Jean Petrilla Jackson in Odessa - Professional
Jean Petrilla Jackson - NPI 1710048830
Jean Petrilla Jackson is a Professional in Odessa, Texas. Jean Petrilla Jackson practices all healthcare services and medical treatments related to Professional. The NPI Number for Jean Petrilla Jackson is 1710048830. The last update date is 2007-07-08.
Jean Petrilla Jackson's current location address is 1200 W 10th St, Odessa, Texas. You can contact this provider via phone number 4325807250 and fax number 4325822020. The mailing address for Jean Petrilla Jackson is 1200 W 10th St, Odessa, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jean Petrilla Jackson |
|---|---|
| Address | 1200 W 10th St, Odessa, Texas |
| Phone Number | 4325807250 |
| Fax Number | 4325822020 |
| Sole Proprietor | Y |
| Credentials | MA, LPC |
NPI Number Detail
| NPI Number | 1710048830 |
|---|---|
| Provider Enumeration Date | 2006-12-12 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1200 W 10th St |
|---|---|
| City | Odessa |
| State | Texas (TX) |
| Post Code | 797633546 |
| Phone Number | 4325807250 |
| Fax Number | 4325822020 |
Provider's Primary Taxonomy Detail
| Speciality | Professional |
|---|---|
| Taxonomy | 101Yp2500X |
| Licence No | 14966 |
|
Definition: A general counselor who helps people with personal, social, educational, and career issues. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3710LC | TX | BLUECROSS BLUESHIELD | |
| 5212693 | AETNA | ||
| 1296590 | CIGNA |
Post Comment/ Review Below
What is the unique identifier code issued to Jean Petrilla Jackson by the Centers for Medicare & Medicaid Services (CMS)?
The Jean Petrilla Jackson has been assigned the NPI (National Provider Identifier) 1710048830. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical location address where Jean Petrilla Jackson's facilities are situated?
The facilities of Jean Petrilla Jackson are physically located at the following address: 1200 W 10Th St, Odessa, TX, 797633546.
What is Jean Petrilla Jackson's area of expertise and its corresponding taxonomy classification?
The Jean Petrilla Jackson's field of specialization is Professional, and it falls under the taxonomy code 101Yp2500X, which categorizes healthcare providers based on their areas of practice.
On what date was the 1710048830 assigned to Jean Petrilla Jackson?
The Jean Petrilla Jackson was issued its 1710048830 on 2006-12-12, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Jean Petrilla Jackson, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Jean Petrilla Jackson, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2007-07-08.