Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ILLYA JACKSON
Active Sole ProprietorILLYA JACKSON is a Marriage & Family Therapist healthcare provider located in FT WORTH, Texas. NPI 1700269149 is currently active in the NPPES registry. Verify at CMS.
Marriage & Family Therapist · FT WORTH, TX
Registration Details
- NPI Number
- 1700269149
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 2, 2015 (10.932989520772 yrs)
- Last Updated
- Jul 2, 2015
- License
-
IACCP0064 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1518 VAUGHN BLVDFT WORTH, TX, 761052307Browse TX providers · Browse ZIP 76105
- Phone
- 2145152079
- Primary Specialty
-
Marriage & Family Therapist
106H00000X
Other Marriage & Family Therapist Providers in FT WORTH, TX
| Name | Credential | NPI |
|---|---|---|
| DR. RICHARD E GARNETT | PH D | 1659385029 |
| DR. CARY LEONARD CLARK SR. | PHD | 1164539516 |
| SHARLA CARPENTER | — | 1497855001 |
| DR. BARBARA J MOORE | EDD | 1962563890 |
| JACQUELINE ANN MANLEY | LMFT | 1801452396 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.