Jackson, Camilla Vawn
Jackson, Camilla Vawn is an sole proprietor health care provider with primary practice located at 1006 Guadalupe St Apt 5C , Kerrville TX 78028-4915. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Jackson, Camilla Vawn can be contacted via phone (830) 496-1419.Contact Information
Primary practice address
1006 Guadalupe St Apt 5C
Kerrville TX 78028-4915
Phone: (830) 496-1419
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 4732 | Texas |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 18405 | Texas |
Profile Details
| NPI number | 1841335916 |
|---|---|
| LBN Legal business name | Jackson, Camilla Vawn |
| Credentials | LMFT, LPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 20th, 2007 |
| Last updated | Apr 4th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841335916 | NPPES |
| Texas | Other | 1841335916 | NPI |
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