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General NPI Number Information
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NPI Number | 1831553155
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Entity Type | Individual
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Provider Name | JENNY GARCIA BROCKWAY M.S., NCC, LPC
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Gender | Female
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Dates
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Enumeration Date | 04/12/2016
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Last Update Date | 04/12/2016
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Provider Practice Location Address
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Address Line | 305 N HEATHERWILDE BLVD STE. 310
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-3757
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Country | US
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Telephone | 512-704-8349
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Fax |
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Provider Business Mailing Address
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Address Line | 305 N HEATHERWILDE BLVD STE. 310
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-3757
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Country | US
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Telephone | 512-704-8349
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 68770
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License Number State | TX
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