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NPI Code Detail

MEDICARE: MRS. JACLYN HERRIG LPC

MEDICARE:  MRS. JACLYN  HERRIG  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 Counselor

General Provider Information

NPI Number : 1194224725
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JACLYN HERRIG LPC
Provider Business Mailing Address
First Line : 3500 OAK LAWN AVE STE 730
Second Line :
City : DALLAS
State : TX
Zip : 75219-6721
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3500 OAK LAWN AVE STE 730
Second Line :
City : DALLAS
State : TX
Zip : 75219-6721
Country : US
Telephone Number : 972-454-9209
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2018
Last Update Date : 10/24/2022

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