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NPI Code Detail

MEDICARE: JENNY WONG LAU LPC-ASSOCIATE

MEDICARE: JENNY WONG LAU LPC-ASSOCIATE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor95457TX

General Provider Information

NPI Number : 1679100093
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNY WONG LAU LPC-ASSOCIATE
Provider Business Mailing Address
First Line : 6001 W PARMER LN STE 370 #72
Second Line :
City : AUSTIN
State : TX
Zip : 78727-3908
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11824 JOLLYVILLE RD STE 103
Second Line :
City : AUSTIN
State : TX
Zip : 78759-2318
Country : US
Telephone Number : 512-270-1064
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2020
Last Update Date : 08/14/2024

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