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Individual
MR. JACKSON B PHILLIPS
Active
Individual
MR. JACKSON B PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704018305
VA
Other
Enumeration date
10/28/2025
Last updated
10/28/2025
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