Individual
LAURA GOSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
711 W 38TH ST, AUSTIN, TX 78705-1121
(512) 450-0909
Mailing address
417 BRADY LN, AUSTIN, TX 78746-5501
(512) 351-0165
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1141877
TX
Other
Enumeration date
09/19/2013
Last updated
09/19/2013
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