Provider Demographics
NPI:1346415502
Name:FLEISCHHAUER, JANA LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:LYNN
Last Name:FLEISCHHAUER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76701-1810
Mailing Address - Country:US
Mailing Address - Phone:254-297-7124
Mailing Address - Fax:254-756-3133
Practice Address - Street 1:110 S 12TH ST
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76701-1810
Practice Address - Country:US
Practice Address - Phone:254-297-7124
Practice Address - Fax:254-756-3133
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61474101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor