Individual
PATIENCE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RELAXATION THERAPIST
Contact information
Practice address
600 W 6TH ST FL 4, FORT WORTH, TX 76102-3684
(805) 221-0208
(469) 754-0469
Mailing address
600 W 6TH ST FL 4, FORT WORTH, TX 76102-3684
(805) 221-0208
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
174H00000X
Health Educator
—
—
221700000X
Art Therapist
—
—
222Q00000X
Developmental Therapist
—
—
225600000X
Dance Therapist
—
—
225A00000X
Music Therapist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/11/2020
Last updated
11/11/2020
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