Provider Demographics
NPI:1174697825
Name:FALLS, JACQUELINE L (MED LPC)
Entity type:Individual
Prefix:MISS
First Name:JACQUELINE
Middle Name:L
Last Name:FALLS
Suffix:
Gender:F
Credentials:MED LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4714 EMERALD LANE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545
Mailing Address - Country:US
Mailing Address - Phone:713-667-4977
Mailing Address - Fax:713-667-4942
Practice Address - Street 1:2626 SOUTH LOOP W
Practice Address - Street 2:#650Z
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054
Practice Address - Country:US
Practice Address - Phone:713-667-4977
Practice Address - Fax:713-667-4942
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17202101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional