Provider Demographics
NPI:1326428194
Name:BAGGERLY, JENNIFER NALINI (PHD, LPC-S, RPT-S)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:NALINI
Last Name:BAGGERLY
Suffix:
Gender:F
Credentials:PHD, LPC-S, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 MAPLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-7130
Mailing Address - Country:US
Mailing Address - Phone:813-598-5735
Mailing Address - Fax:
Practice Address - Street 1:1933 MAPLEWOOD LN
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-7130
Practice Address - Country:US
Practice Address - Phone:813-598-5735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67446101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health