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NPI Code Detail

MEDICARE: MRS. LATOYA C MARTIN-JACKSON MA, LPC

MEDICARE:  MRS. LATOYA C MARTIN-JACKSON  MA, LPC
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 Counselor66427TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962790675
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LATOYA C MARTIN-JACKSON MA, LPC
Provider Business Mailing Address
First Line : 19123 DAWNTREADER DR
Second Line :
City : CYPRESS
State : TX
Zip : 77429-4323
Country : US
Telephone Number : 281-746-2704
Fax Number : 832-413-5072
Provider Business Practice Location Address
First Line : 8300 FM 1960 RD W
Second Line : SUITE 450
City : HOUSTON
State : TX
Zip : 77070-5654
Country : US
Telephone Number : 281-746-2704
Fax Number : 832-413-5072
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2011
Last Update Date : 07/31/2015

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Directions to “ MRS. LATOYA C MARTIN-JACKSON MA, LPC” Practice Location

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