Individual
JACKSON REAP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC - A
Contact information
Practice address
13140 COIT RD STE 518, DALLAS, TX 75240-5725
(214) 307-2451
Mailing address
13140 COIT RD STE 518, DALLAS, TX 75240-5725
(214) 307-2451
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
96204
TX
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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