Individual
JILL FENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 LAKEWAY DR STE 10, LAKEWAY, TX 78734-4456
(512) 477-5445
Mailing address
1200 LAKEWAY DR STE 10, LAKEWAY, TX 78734-4456
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
76208
TX
Other
Enumeration date
07/18/2016
Last updated
06/11/2022
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