Provider Demographics
NPI:1457409641
Name:GRAJKOWSKI, PATRICIA H
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:H
Last Name:GRAJKOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:GRAJKOWSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, LMFT
Mailing Address - Street 1:8415 FENTON DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78736-3127
Mailing Address - Country:US
Mailing Address - Phone:512-894-0422
Mailing Address - Fax:512-288-5193
Practice Address - Street 1:14101 W HIGHWAY 290
Practice Address - Street 2:STE. 213
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-9336
Practice Address - Country:US
Practice Address - Phone:512-894-0422
Practice Address - Fax:512-288-5193
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9804101YP2500X
TX2926106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist