Provider Demographics
NPI:1336878289
Name:HARGROVE, JANETTE E
Entity Type:Individual
Prefix:
First Name:JANETTE
Middle Name:E
Last Name:HARGROVE
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 1:5521 GREENWOOD CREEK DR APT 252
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76109-3976
Mailing Address - Country:US
Mailing Address - Phone:254-967-6289
Mailing Address - Fax:
Practice Address - Street 1:1400 N CORINTH ST STE 109
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76208-5444
Practice Address - Country:US
Practice Address - Phone:254-967-6289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health