Individual
ANNE DESLOGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4312 MARATHON BLVD, AUSTIN, TX 78756-3427
(512) 773-8040
Mailing address
4312 MARATHON BLVD, AUSTIN, TX 78756-3427
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
58373
TX
Other
Enumeration date
04/01/2014
Last updated
04/01/2014
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