Individual
JACQUELIN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RSPS
Contact information
Practice address
2206 QUAIL HOLLOW DR, BRYAN, TX 77802-2919
(512) 939-4843
Mailing address
2206 QUAIL HOLLOW DR, BRYAN, TX 77802-2919
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
12830721
TX
Other
Enumeration date
09/28/2021
Last updated
09/28/2021
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