Individual
MS. MAGNOLIA DELOISE CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
1165 AIRPORT BLVD, AUSTIN, TX 78702-3152
(512) 804-3517
Mailing address
1430 COLLIER ST, AUSTIN, TX 78704-2911
(512) 472-4357
(512) 703-1394
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15384
TX
Other
Enumeration date
09/04/2020
Last updated
09/04/2020
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