Individual
JESSICA GROGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LMFT-A
Contact information
Practice address
821 W 11TH ST, AUSTIN, TX 78701-2009
(512) 993-1616
Mailing address
821 W 11TH ST, AUSTIN, TX 78701-2009
(512) 993-1616
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
202363
TX
Other
Enumeration date
02/13/2015
Last updated
02/13/2015
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