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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 2 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 1841335916 NPPES
Texas Other 1841335916 NPI

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