Individual
MS. MIRIAM L NISENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACSW, LMSW
Contact information
Practice address
1611 HEADWAY CIR, AUSTIN, TX 78754-5160
(512) 615-6802
(512) 615-7121
Mailing address
4804 MISTY BROOK CV, AUSTIN, TX 78727-6817
(512) 615-6802
(512) 615-7121
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
00632
TX
Other
Enumeration date
02/02/2010
Last updated
02/02/2010
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