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NPI Code Detail

MEDICARE: JOTINA LASHA BUCK

MEDICARE: JOTINA LASHA BUCK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor
2101YM0800XMental Health Counselor87555TX

General Provider Information

NPI Number : 1467271346
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOTINA LASHA BUCK
Provider Business Mailing Address
First Line : 4422 STERLING ST
Second Line :
City : HOUSTON
State : TX
Zip : 77051-2640
Country : US
Telephone Number : 281-923-0306
Fax Number :
Provider Business Practice Location Address
First Line : 2021 GUADALUPE ST STE 260
Second Line :
City : AUSTIN
State : TX
Zip : 78705-5654
Country : US
Telephone Number : 646-941-7645
Fax Number : 929-596-7897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2024
Last Update Date : 06/25/2026

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Directions to “ JOTINA LASHA BUCK ” Practice Location

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