Provider Demographics
NPI:1881415081
Name:ANGLIN, JAZZMINE (LCSW)
Entity type:Individual
Prefix:
First Name:JAZZMINE
Middle Name:
Last Name:ANGLIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 LCR 474
Mailing Address - Street 2:
Mailing Address - City:MEXIA
Mailing Address - State:TX
Mailing Address - Zip Code:76667-2975
Mailing Address - Country:US
Mailing Address - Phone:214-669-0305
Mailing Address - Fax:
Practice Address - Street 1:1133 LCR 474
Practice Address - Street 2:
Practice Address - City:MEXIA
Practice Address - State:TX
Practice Address - Zip Code:76667-2975
Practice Address - Country:US
Practice Address - Phone:214-669-0305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX624831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical