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Individual

CARMELLIA KAY JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CSW, MFT-ASSOCIATE

Contact information

Practice address
330 RACE ST, SOMERSET, KY 42501-2156
(502) 509-9772
Mailing address
10 TAMARACK DR, JEFFERSONVILLE, IN 47130-5431
(606) 802-3779

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
276506
KY

Other

Enumeration date
01/05/2024
Last updated
01/05/2024
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