Individual
CAROL ANN JAQUITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
56 EAST AVE, AUSTIN, TX 78701-4323
(512) 703-1312
(512) 703-1390
Mailing address
7807 WILLIAMSON CREEK DR, AUSTIN, TX 78736-2976
(512) 940-0191
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
18022
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211799604
—
TX
Enumeration date
06/04/2010
Last updated
06/11/2015
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