MEDICARE: NATALY SAUCEDA LMSW

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	104100000X	Social Worker	64839	TX

General Provider Information

NPI Number	:	1619495710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALY SAUCEDA LMSW

Provider Business Mailing Address
First Line	:	1430 COLLIER ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-2911
Country	:	US
Telephone Number	:	512-472-4357
Fax Number	:	512-703-1394

Provider Business Practice Location Address
First Line	:	1701 TRINITY ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78712-1746
Country	:	US
Telephone Number	:	512-495-5335
Fax Number	:

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

Provider Enumeration Date	:	09/08/2017
Last Update Date	:	09/08/2017

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