Provider Information for 1609414796
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MAYSUN ELNIHUM LPC
Sex: Female
NPI: 1609414796
Last Updated: 2023-10-19
Certification Date: 2023-10-19
Certification Date: 2023-10-19
Details
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NPI | 1609414796 | ||||||||||||
Enumeration Date | 2019-12-19 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | YES | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 2025 GUADALUPE ST AUSTIN, TX 78705-5618 United States Phone: 512-843-1642 | Fax: | ||||||||||||
Primary Practice Address | 2025 GUADALUPE ST AUSTIN, TX 78705-5618 United States Phone: 979-450-9440 | Fax: | ||||||||||||
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