Individual
DR. JENNIFER LEE FAST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
211 E 7TH ST STE 620, AUSTIN, TX 78701-3218
(800) 370-3651
Mailing address
18 CAMPUS CIR, LAKE FOREST, IL 60045-2342
(708) 334-7508
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071008255
IL
103TC0700X
Clinical Psychologist
Primary
38062
TX
Other
Enumeration date
05/11/2016
Last updated
12/19/2018
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