Provider Demographics
NPI:1558018119
Name:GOGGINS, HANNAH MARIE
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:MARIE
Last Name:GOGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 LEGACY LN
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-1800
Mailing Address - Country:US
Mailing Address - Phone:832-720-2541
Mailing Address - Fax:
Practice Address - Street 1:6104 OLD FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-1216
Practice Address - Country:US
Practice Address - Phone:512-423-4467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty