Individual
BRYCE MOFFETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
100 W DEAN KEETON ST FL 5, AUSTIN, TX 78712-1091
(512) 471-3515
(512) 471-0898
Mailing address
407 W ODELL ST, AUSTIN, TX 78752-2407
(540) 533-4643
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
218035
MA
1041C0700X
Clinical Social Worker
Primary
105489
TX
1041C0700X
Clinical Social Worker
LC50080638
DC
Other
Enumeration date
07/17/2013
Last updated
09/15/2021
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