Individual
AMY SUZANNE GRAGERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,LPC-S
Contact information
Practice address
2610 STATE ST, DALLAS, TX 75204-2622
(214) 641-4545
Mailing address
2610 STATE ST, DALLAS, TX 75204-2622
(214) 641-4545
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
12371
TX
Other
Enumeration date
12/26/2018
Last updated
12/26/2018
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