Jacklyn Sue Bascomb-Harrison, MS, ATC
Specialist/Technologist, Athletic Trainer in College Station, TX. Individual provider (NPI-1).
NPI number1164935367
StatusActive
Last updated in NPPESJan 25, 2023
Details
- NPI
- 1164935367
- Entity type
- Individual (NPI-1)
- Name
- Jacklyn Sue Bascomb-Harrison
- Credential
- MS, ATC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 9, 2017
- Certification date
- Jan 25, 2023
- Last updated
- Jan 25, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Other names
- Jacklyn Sue Bascomb (Former Name)
Practice location
400 Bizzell StCollege Station, TX 77843-0002
Phone 979-458-0257
Mailing address
984 Rice DrBryan, TX 77803-1867
Phone 970-301-7183
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