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General NPI Number Information
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NPI Number | 1558018119
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Entity Type | Individual
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Provider Name | MS. HANNAH MARIE GOGGINS
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Gender | Female
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Dates
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Enumeration Date | 03/03/2022
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 161 SUMMIT AVE STE 200
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City | SOUTHLAKE
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State | TX
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Zip | 76092-7072
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Country | US
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Telephone | 214-494-9779
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Fax |
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Provider Business Mailing Address
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Address Line | 1443 CIMARRON TRL
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City | HURST
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State | TX
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Zip | 76053-3921
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Country | US
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Telephone | 832-720-2541
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 99090
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License Number State | TX
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