MEDICARE: MS. ALICIA MCNANY 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	101YP2500X	Professional Counselor	70595	TX

General Provider Information

NPI Number	:	1326434473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALICIA MCNANY L.P.C.

Provider Business Mailing Address
First Line	:	6704 MANCHACA RD
Second Line	:	UNIT 7
City	:	AUSTIN
State	:	TX
Zip	:	78745-4977
Country	:	US
Telephone Number	:	512-366-5053
Fax Number	:

Provider Business Practice Location Address
First Line	:	2222 WESTERN TRAILS BLVD
Second Line	:	SUITE 205
City	:	AUSTIN
State	:	TX
Zip	:	78745-1682
Country	:	US
Telephone Number	:	512-705-7018
Fax Number	:

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

Provider Enumeration Date	:	04/15/2015
Last Update Date	:	04/15/2015

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