Provider Demographics
NPI:1922660091
Name:AUSTIN THERAPY CONNECTION, PLLC
Entity Type:Organization
Organization Name:AUSTIN THERAPY CONNECTION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:JOANN
Authorized Official - Last Name:DAUB
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LMFT
Authorized Official - Phone:512-309-0339
Mailing Address - Street 1:4422 PACK SADDLE PASS STE 203
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1644
Mailing Address - Country:US
Mailing Address - Phone:512-309-0339
Mailing Address - Fax:
Practice Address - Street 1:4422 PACK SADDLE PASS STE 203
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1644
Practice Address - Country:US
Practice Address - Phone:512-309-0339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health