Individual
DR. JACOB O WASONGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D, LMFT
Contact information
Practice address
1124 GALVESTON AVE STE B, FORT WORTH, TX 76104-4878
(210) 420-8117
Mailing address
PO BOX 592732, SAN ANTONIO, TX 78259-0186
(817) 609-2289
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
203024
TX
Other
Enumeration date
09/23/2019
Last updated
12/14/2020
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