Mixson, Jennifer J

Mixson, Jennifer J is an individual health care provider with primary practice located at 15521 Midlothian Tpke Ste 105 , Midlothian VA 23113-7313. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Mixson, Jennifer J can be contacted via phone (804) 207-6737.

Contact Information

Primary practice address
15521 Midlothian Tpke Ste 105 Midlothian VA 23113-7313
Phone: (804) 207-6737
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701006293 Virginia

Profile Details

NPI number 1396115960
LBN Legal business name Mixson, Jennifer J
Credentials MS, LPC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2015
Last updated Nov 28th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396115960 NPPES
Virginia MEDICAID 30016005760002

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