Individual
CEYLI JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5100 PECAN BROOK DR, AUSTIN, TX 78724-3302
(512) 537-1957
Mailing address
PO BOX 113, MANOR, TX 78653-0113
(512) 537-1957
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
Primary
—
—
Other
Enumeration date
05/07/2022
Last updated
09/14/2022
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