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:
Health care specialties
Specialty | Code | License # | 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 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1396115960 | NPPES |
Virginia | MEDICAID | 30016005760002 |
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