Individual
JENNIFER ELAINE BRASHEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
2323 W FRONT ST, TYLER, TX 75702-7747
(903) 597-1351
Mailing address
PO BOX 4730, TYLER, TX 75712-4730
(035) 971-3519
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
18371
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
8643
TX
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081844501
—
TX
Enumeration date
01/09/2007
Last updated
07/09/2024
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