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Individual
ROLANDA YVETTE JACKSON
Active
Individual
ROLANDA YVETTE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
Primary
111313
TX
1041C0700X
Clinical Social Worker
LCSW798
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5088
TRICARE
—
Enumeration date
01/15/2010
Last updated
04/17/2026
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