MEDICARE: MS. KATHRYN ANN CHARYK MS

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	170300000X	Genetic Counselor (M.S.)	0420	SD
2	170300000X	Genetic Counselor (M.S.)	GEN-GEN-LIC-000482	MT
3	170300000X	Genetic Counselor (M.S.)	GC-595	FL
4	170300000X	Genetic Counselor (M.S.)	80333115-3602	UT

General Provider Information

NPI Number	:	1447532569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHRYN ANN CHARYK MS

Provider Business Mailing Address
First Line	:	823 CONGRESS AVE STE 1200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-2402
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	823 CONGRESS AVE STE 1200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-2402
Country	:	US
Telephone Number	:	888-494-7333
Fax Number	:

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

Provider Enumeration Date	:	09/14/2011
Last Update Date	:	01/25/2024

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