Most Relevant Information
Provider Data
| NPI Number: | 1003586595 |
| Provider Name: | JAQUAVIA LYNN DEMUS LBSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 15954 |
Most Important Dates
| Enumeration Date: | 09/15/2021 |
| Last Updated: | 08/23/2024 |
Provider Practice Location
4931 CALLERY CREEK DR
HOUSTON
TX
770533123
Practice Location Phone/Fax
| Phone: | 3467751129 |
| Fax: |
Provider Mailing Location
4931 CALLERY CREEK DR
HOUSTON
TX
770533123
Provider Mailing Phone/Fax
| Phone: | 3467751129 |
| Fax: |