Individual
MEREDITH JANE MORMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1250 S AW GRIMES BLVD, ROUND ROCK, TX 78664-7429
(512) 661-4387
Mailing address
1250 S AW GRIMES BLVD, ROUND ROCK, TX 78664-7429
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
203264
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203264
STATE LICENSE
TX
Enumeration date
01/07/2022
Last updated
01/07/2022
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