Individual
MS. PHYLLIS KAY MOCZYGEMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
1825 FORTVIEW RD STE 106, AUSTIN, TX 78704-7600
(512) 653-8922
Mailing address
1825 FORTVIEW RD STE 106, AUSTIN, TX 78704-7600
(512) 653-8922
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2680
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2680
TX
Other
Enumeration date
05/11/2011
Last updated
04/19/2019
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