Jackson, Katodra

Jackson, Katodra is an sole proprietor health care provider with primary practice located at 100 W Central Texas Expy Ste. 208, Harker Heights TX 76548-2079. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Jackson, Katodra can be contacted via phone (254) 289-4322.

Contact Information

Primary practice address
100 W Central Texas Expy Ste. 208 Harker Heights TX 76548-2079
Phone: (254) 289-4322
Fax: (254) 634-5222
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 61137 Texas

Profile Details

NPI number 1184844763
LBN Legal business name Jackson, Katodra
Credentials M.S., LPC, NCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 26th, 2007
Last updated Jan 23rd, 2023 - about last year

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 1184844763 NPPES
Texas MEDICAID 182509303
Texas MEDICAID 182509301

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