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Individual

JILL KOLSTAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED

Contact information

Practice address
6205 FALLOW CT, FORT WORTH, TX 76132-3544
(903) 724-9985
(817) 423-0787
Mailing address
6205 FALLOW CT, FORT WORTH, TX 76132-3544
(903) 724-9985
(817) 423-0787

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
495743
TX
174400000X
Specialist
Primary
495743
TX

Other

Enumeration date
04/18/2012
Last updated
04/18/2012
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