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General NPI Number Information
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NPI Number | 1881151819
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Entity Type | Organization
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Legal Business Name | COUNSELING OFFICES OF AMY S. GRAGERT, P.A.
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Dates
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Enumeration Date | 02/26/2019
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Last Update Date | 02/26/2019
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Provider Practice Location Address
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Address Line | 2610 STATE ST
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City | DALLAS
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State | TX
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Zip | 75204-2622
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Country | US
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Telephone | 214-641-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 2610 STATE ST
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City | DALLAS
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State | TX
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Zip | 75204-2622
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Country | US
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Telephone | 214-641-4545
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT/PSYCHOTHERAPIST
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Name | AMY SUZANNE GRAGERT
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Credential | MA,LPC-S, PA
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Telephone | 214-641-4545
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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 |
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License Number State |
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