Basic Information
| Provider Information | |||||||||
| NPI: | 1447562657 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOSSMAN | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1631 E 2ND ST | ||||||||
| Address2: | BLDG E | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787024490 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5128043650 | ||||||||
| FaxNumber: | 5124760217 | ||||||||
| Practice Location | |||||||||
| Address1: | 1631 E 2ND ST | ||||||||
| Address2: | BLDG E | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787024490 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5128043650 | ||||||||
| FaxNumber: | 5124760217 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2010 | ||||||||
| LastUpdateDate: | 07/06/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 64134 | TX | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.