MEDICARE: CONNIE LEU DOLAND MAHS, L.P.C.

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	101YM0800X	Mental Health Counselor	16821	TX
2	101YP2500X	Professional Counselor	16821	TX

General Provider Information

NPI Number	:	1164542833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNIE LEU DOLAND MAHS, L.P.C.

Provider Business Mailing Address
First Line	:	13317 BOSSWOOD DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78727-3338
Country	:	US
Telephone Number	:	512-796-1961
Fax Number	:

Provider Business Practice Location Address
First Line	:	13317 BOSSWOOD DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78727-3338
Country	:	US
Telephone Number	:	512-796-1961
Fax Number	:

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	09/23/2015

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Directions to “ CONNIE LEU DOLAND MAHS, L.P.C.” Practice Location

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