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NPI Code Detail

MEDICARE: JELKA JONKER LMFT

MEDICARE:   JELKA  JONKER  LMFT
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
1106H00000XMarriage & Family Therapist5041TX

General Provider Information

NPI Number : 1760074033
Entity Type Code : Individual
Provider Name (Legal Business Name) : JELKA JONKER LMFT
Provider Business Mailing Address
First Line : 7419 DALLAS DR
Second Line :
City : AUSTIN
State : TX
Zip : 78729-7768
Country : US
Telephone Number : 512-217-7353
Fax Number :
Provider Business Practice Location Address
First Line : 7419 DALLAS DR
Second Line :
City : AUSTIN
State : TX
Zip : 78729-7768
Country : US
Telephone Number : 512-217-7353
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2021
Last Update Date : 06/20/2024

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Directions to “ JELKA JONKER LMFT” Practice Location

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