Individual
MICAH ANGELA WOOD HERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 ROSEWOOD AVE APT A, AUSTIN, TX 78702-2267
(832) 492-0965
Mailing address
2200 ROSEWOOD AVE APT A, AUSTIN, TX 78702-2267
(832) 492-0965
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
231018
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205509883894
BLS PROVIDER
—
01
—
231018
REGISTERED PHARMACY TECHNICIAN
TX
Enumeration date
04/11/2021
Last updated
04/11/2021
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