| Doctor Name: | REGINALD GERARD JEFFERSON |
| NPI Number: | 1871894535 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NCC, LPC, LMFTA |
| License Number: | 65190 |
| Business Practice Address: | 24034 Rockin Seven Dr Hockley, TX - 774479201 |
| Business Phone Number: | 2813730105 |
| Business Fax Number: | |
| Mailing Address: | 24034 Rockin Seven Dr, HOCKLEY |
| State: | TX |
| Postal Code: | 774479201 |
| Phone Number: | 2813730105 |
| Fax Number: | |
| NPI Enumeration Date: | 11/11/2010 |
| NPI Last Update Date: | 11/11/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 65190 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |