Individual
JAYVONNA AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
655 S 23RD ST TRLR 69, BEAUMONT, TX 77707-3836
(409) 658-2139
Mailing address
2720 HOUSTON ST, BEAUMONT, TX 77701-8007
(409) 658-2149
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
16719
TX
101YP1600X
Pastoral Counselor
16719
TX
101YP2500X
Professional Counselor
16719
TX
Other
Enumeration date
03/24/2022
Last updated
03/25/2022
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