Individual
VICKI JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4136 BARTLETT ST, HOMER, AK 99603-7001
(907) 235-6127
Mailing address
818 SMOKY BAY WAY # 140, HOMER, AK 99603-7653
(509) 496-9116
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/22/2016
Last updated
10/22/2021
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