Provider Demographics
NPI:1912006073
Name:DRAKE, ANN M (MA RN CS LMFT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:DRAKE
Suffix:
Gender:F
Credentials:MA RN CS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4131 SPICEWOOD SPRINGS ROAD
Mailing Address - Street 2:BLD K SUITE 4 K-4
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759
Mailing Address - Country:US
Mailing Address - Phone:512-345-7270
Mailing Address - Fax:512-345-1746
Practice Address - Street 1:4131 SPICEWOOD SPRINGS ROAD
Practice Address - Street 2:K-4
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759
Practice Address - Country:US
Practice Address - Phone:512-345-7270
Practice Address - Fax:512-345-1746
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX004590042453LMFT106H00000X
TX611024163W00000X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00051BOtherBCBS