Individual
HEATHER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
107 AMAR PL STE 102, PANAMA CITY BEACH, FL 32413-5014
(850) 419-7736
(850) 328-4010
Mailing address
256 CARSON OAKS LN, SANTA ROSA BEACH, FL 32459-7149
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MH 14095
FL
Other
Enumeration date
05/18/2016
Last updated
07/19/2023
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