Individual provider · Type 1 NPI
Jahn Quattlebaum
Mental Health Counselor · Tyler, TX
NPI number
1821577628
Active
Practice location
6200 Wilshire Dr
Tyler, TX 75703-4159
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 12272 (TX) |
| Mental Health Counselor | 101YM0800X | LPC.0014807 (CO) |
| Mental Health Counselor Primary | 101YM0800X | 71752 (TX) |
Mental Health Counselor: Definition to come...
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About NPI 1821577628
Jahn Quattlebaum's National Provider Identifier is 1821577628, issued on Aug 13, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Tyler, TX. The record was last updated on Aug 13, 2018.