Organization
TIA CONOS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SALLY DEGOLLADO HOWARD LCSW (OWNER)
(512) 796-0123
Entity
Organization
Contact information
Practice address
5120 BANTOM WOODS BND, AUSTIN, TX 78724-6235
(512) 992-1411
Mailing address
PO BOX 2401, AUSTIN, TX 78768-2401
(512) 992-1411
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/24/2013
Last updated
01/24/2013
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