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Individual

AHRIELLE JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5341 THRESHING DR, FORT WORTH, TX 76179-8147
(910) 545-4189
Mailing address
700 SMITH ST # 61070, HOUSTON, TX 77002-2714
(817) 369-5528

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
68117
TX
104100000X
Social Worker
68117
TX

Other

Enumeration date
04/16/2020
Last updated
08/12/2024
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