MEDICARE: J10 INTERNATIONAL

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
1	251B00000X	Case Management Agency	70567	TX
2	251S00000X	Community/Behavioral Health Agency	70567	TX

General Provider Information

NPI Number	:	1184008161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J10 INTERNATIONAL

Provider Business Mailing Address
First Line	:	1001 PAT BOOKER RD
Second Line	:	SUITE 208
City	:	UNIVERSAL CITY
State	:	TX
Zip	:	78148-4154
Country	:	US
Telephone Number	:	210-885-0082
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 PAT BOOKER RD
Second Line	:	SUITE 208
City	:	UNIVERSAL CITY
State	:	TX
Zip	:	78148-4154
Country	:	US
Telephone Number	:	210-885-0082
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	MS. JOCELYN MONICA JOHNSON
Credential	:	LPC
Telephone Number	:	210-885-0082

Provider Enumeration Date	:	07/20/2015
Last Update Date	:	08/13/2015

Similar Medicare Providers

1841281656 — MRS. BEVERLY A HIME M.A., LPC
Practice Location Address:

1001 PAT BOOKER RD , SUITE 208
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78148-4154

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1811189244 — SHERI COBARRUVIAS LPC-S
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1366825671 — JOCELYN MONICA JOHNSON LPC
Practice Location Address:

1001 PAT BOOKER RD , STE 208
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78148-4154

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1063875276 — INTERNATIONAL THERAPY TEAM PLLC
Practice Location Address:

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Practice Location Address:

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1497636997 — STEVEN ANTHONY CAMPBELL RBT
Practice Location Address:

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Directions to “J10 INTERNATIONAL ” Practice Location

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