person
Mr. Jackie Wayne Vaughn JR., LPC
Professional Counselor in Fort Worth, Texas
NPI 1013159045

Jackie Wayne Vaughn JR. is a Professional Counselor based in Fort Worth, TX and is specialized in Professional. Jackie Wayne Vaughn JR. practices in Fort Worth, TX and has the professional credentials of LPC. The NPI Number for Jackie Wayne Vaughn JR. is 1013159045 and holds a License No. 57085 (Texas).

The current practice location address for Jackie Wayne Vaughn JR. is 3800 Hulen St Ste 150, Fort Worth, TX and can be reached out via phone at 817-255-2652 and via fax at 817-255-2657.

Location: 3800 Hulen St Ste 150, Fort Worth, TX, 76107-5336
person
Provider Profile Details
NPI Number
1013159045
Provider Name
Jackie Wayne Vaughn JR.
Credential
LPC
Provider Entity Type
Individual
Gender
Male
Address
3800 Hulen St Ste 150, Fort Worth, TX, 76107-5336
Phone Number
817-255-2652
Fax Number
817-255-2657
Provider Enumeration Date
04/06/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
203131201 05 TX
institution
Provider Business Practice Location Address Details
Address
3800 Hulen St Ste 150
City
State
Zip
76107-7254
Phone Number
817-255-2652
Fax Number
817-255-2657
person
Provider Business Mailing Address Details
Address
3800 Hulen St Ste 150
City
State
Zip
76107-7254
Phone Number
817-255-2652
Fax Number
817-255-2657
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
57085 (Texas)
Definition
Definition to come...
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