| Self Center Pllc | |
|
1010 Williams Lake Dr Richmond TX 77469-4295 | |
| (601) 807-5030 | |
| Not Available |
| Full Name | Self Center Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1010 Williams Lake Dr, Richmond, Texas |
| Authorized Official Name and Position | Natalie Jackson (DIRECTOR) |
| Authorized Official Contact | 6018075030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Self Center Pllc 1010 Williams Lake Dr Richmond TX 77469-4295 Ph: (601) 807-5030 | Self Center Pllc 1010 Williams Lake Dr Richmond TX 77469-4295 Ph: (601) 807-5030 |
| NPI Number | 1174235758 |
|---|---|
| Provider Enumeration Date | 12/15/2022 |
| Last Update Date | 12/15/2022 |
| Certification Date | 12/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174235758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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