MEDICARE: REBECCA COHN

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	109562	TX

General Provider Information

NPI Number	:	1891541694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA COHN

Provider Business Mailing Address
First Line	:	3709 FORT COLLINS WAY
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-2415
Country	:	US
Telephone Number	:	512-627-0507
Fax Number	:

Provider Business Practice Location Address
First Line	:	3709 FORT COLLINS WAY
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-2415
Country	:	US
Telephone Number	:	512-627-0507
Fax Number	:

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

Provider Enumeration Date	:	04/24/2024
Last Update Date	:	04/24/2024

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Directions to “ REBECCA COHN ” Practice Location

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