Provider Demographics
NPI:1376111260
Name:DOCK, JAMIE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:DOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 ASHLEY FALLS LN
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-1388
Mailing Address - Country:US
Mailing Address - Phone:832-814-2105
Mailing Address - Fax:
Practice Address - Street 1:20351 HIGHWAY 6 STE B
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-3882
Practice Address - Country:US
Practice Address - Phone:979-233-1584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional