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NPI Code Detail

MEDICARE: MRS. KATHRYN MARIE LAROSA LCSW

MEDICARE: MRS. KATHRYN MARIE LAROSA 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
1101Y00000XCounselor35421TX

General Provider Information

NPI Number : 1245420546
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHRYN MARIE LAROSA LCSW
Provider Business Mailing Address
First Line : 2802 WEBBERVILLE RD
Second Line :
City : AUSTIN
State : TX
Zip : 78702-2947
Country : US
Telephone Number : 512-972-4419
Fax Number :
Provider Business Practice Location Address
First Line : 2802 WEBBERVILLE RD
Second Line :
City : AUSTIN
State : TX
Zip : 78702-2947
Country : US
Telephone Number : 512-972-4419
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2007
Last Update Date : 08/01/2007

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