MEDICARE: CARA M EDMOND 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	171M00000X	Case Manager/Care Coordinator	51111	TX

General Provider Information

NPI Number	:	1841594348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARA M EDMOND LMSW

Provider Business Mailing Address
First Line	:	903 SILVER QUAIL LN
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-5821
Country	:	US
Telephone Number	:	512-470-6659
Fax Number	:

Provider Business Practice Location Address
First Line	:	903 SILVER QUAIL LN
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-5821
Country	:	US
Telephone Number	:	512-470-6659
Fax Number	:

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

Provider Enumeration Date	:	12/27/2010
Last Update Date	:	12/27/2010

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