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Individual

JENNIFER SAMUEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
4200 S HULEN ST STE 450, FORT WORTH, TX 76109-4910
(817) 374-4401
Mailing address
1877 PARK ST, AZLE, TX 76020-3743
(817) 374-4401

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
82913
TX

Other

Enumeration date
10/30/2023
Last updated
10/30/2023
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