Shannon, Jacqueline A

Shannon, Jacqueline A is an individual health care provider with primary practice located at 3840 Hulen St , Fort Worth TX 76107-7277. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Shannon, Jacqueline A can be contacted via phone (817) 335-3022.

Contact Information

Primary practice address
3840 Hulen St Fort Worth TX 76107-7277
Phone: (817) 335-3022
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 101YS0200X 76758 Texas
Behavioral Health & Social Service Providers / Professional 101YP2500X 76758 Texas

Profile Details

NPI number 1730651696
LBN Legal business name Shannon, Jacqueline A
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 17th, 2018
Last updated Feb 8th, 2019 - about 5 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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