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Individual

JASPER BRYAN GATES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
12715 TELGE RD, CYPRESS, TX 77429-2289
(713) 466-1360
Mailing address
12715 TELGE RD, CYPRESS, TX 77429-2289
(281) 989-1053

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
74906
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
74906
LPC
TX
Enumeration date
08/21/2019
Last updated
08/21/2019
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