Individual
JENNA MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
1501 AIRPORT RD, WAUKESHA, WI 53188-2461
(262) 548-7666
Mailing address
N961 FOX RUN LN APT 5, OCONOMOWOC, WI 53066-9587
(262) 370-1041
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20708-130
WI
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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