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Organization
PERMANENT RESOLUTIONS
Active
Organization
PERMANENT RESOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARILYN R. JACKSON LPC (PRESIDENT)
(972) 283-1050
Entity
Organization
Contact information
Practice address
407 N CEDAR RIDGE DR STE 325, DUNCANVILLE, TX 75116-3170
(972) 283-1050
(972) 283-0352
Mailing address
PO BOX 381465, DUNCANVILLE, TX 75138-1465
(972) 283-1050
(972) 283-0352
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
63045
TX
225X00000X
Occupational Therapist
102004
TX
235Z00000X
Speech-Language Pathologist
16724
TX
Other
Enumeration date
04/09/2009
Last updated
04/09/2009
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