MEDICARE: MRS. JANET ELISE KAUTZ LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	3571	TX

General Provider Information

NPI Number	:	1114927233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANET ELISE KAUTZ LCSW

Provider Business Mailing Address
First Line	:	12885 RESEARCH BLVD
Second Line	:	ARBOR SQUARE #209-A
City	:	AUSTIN
State	:	TX
Zip	:	78750-3220
Country	:	US
Telephone Number	:	512-250-1015
Fax Number	:	512-250-2110

Provider Business Practice Location Address
First Line	:	12885 RESEARCH BLVD
Second Line	:	ARBOR SQUARE #209-A
City	:	AUSTIN
State	:	TX
Zip	:	78750-3220
Country	:	US
Telephone Number	:	512-250-1015
Fax Number	:	512-250-2110

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	07/08/2007

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