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General NPI Number Information
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NPI Number | 1053665281
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Entity Type | Organization
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Legal Business Name | JENNIFER L. ROCKETT, PH.D.
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 2402 BROADMOOR DR BUILDING DII SUITE 111
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City | BRYAN
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State | TX
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Zip | 77802-2847
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Country | US
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Telephone | 979-450-5320
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Fax | 979-713-1245
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Provider Business Mailing Address
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Address Line | PO BOX 9276
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City | COLLEGE STATION
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State | TX
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Zip | 77842-9276
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Country | US
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Telephone | 979-450-5320
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Fax | 979-713-1245
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | DR. JENNIFER LYNN ROCKETT
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Credential | PH.D.
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Telephone | 979-450-5320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 36024
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 36024
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License Number State | TX
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