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Individual

MR. BRENTOM E. JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
6961 NE LOOP 820 APT 423, NORTH RICHLAND HILLS, TX 76180-6694
(512) 786-3107
Mailing address
6961 NE LOOP 820 APT 423, NORTH RICHLAND HILLS, TX 76180-6694
(512) 786-3107

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
68645
TX

Other

Enumeration date
11/08/2017
Last updated
11/08/2017
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