Individual
MR. JONATHAN BLAKE VARDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C
Contact information
Practice address
425 UNIVERSITY BLVD, ROUND ROCK, TX 78665-1047
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-3855
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
74175
TX
Other
Enumeration date
05/29/2013
Last updated
05/07/2024
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