Jacquelin Johnson, RSPS
Counselor in Bryan, TX. Individual provider (NPI-1).
NPI number1992477004
StatusActive
Last updated in NPPESSep 28, 2021
Details
- NPI
- 1992477004
- Entity type
- Individual (NPI-1)
- Name
- Jacquelin Johnson
- Credential
- RSPS
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 28, 2021
- Certification date
- Sep 22, 2021
- Last updated
- Sep 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | 12830721 | TX | Yes |
Other names
- Jacqulin Shelby (Other Name)
Practice location
2206 Quail Hollow DrBryan, TX 77802-2919
Phone 512-939-4843
Mailing address
2206 Quail Hollow DrBryan, TX 77802-2919
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