MEDICARE: MRS. MARTINE GOULD HUSLIG M.S.

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.)

General Provider Information

NPI Number	:	1881865897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARTINE GOULD HUSLIG M.S.

Provider Business Mailing Address
First Line	:	2110 UPPER BRANCH CV
Second Line	:
City	:	DRIPPING SPRINGS
State	:	TX
Zip	:	78620-4203
Country	:	US
Telephone Number	:	512-858-7939
Fax Number	:

Provider Business Practice Location Address
First Line	:	2110 UPPER BRANCH CV
Second Line	:
City	:	DRIPPING SPRINGS
State	:	TX
Zip	:	78620-4203
Country	:	US
Telephone Number	:	512-858-7939
Fax Number	:

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

Provider Enumeration Date	:	03/18/2008
Last Update Date	:	03/18/2008

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