Provider Demographics
NPI:1831478767
Name:POTEET, JACQUELYN ELAYNE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JACQUELYN
Middle Name:ELAYNE
Last Name:POTEET
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-7440
Mailing Address - Country:US
Mailing Address - Phone:832-425-2271
Mailing Address - Fax:713-802-7743
Practice Address - Street 1:4950 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-7440
Practice Address - Country:US
Practice Address - Phone:832-425-2271
Practice Address - Fax:713-802-7743
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201380101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor