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Individual

JOSEPH S JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
1011 37TH AVENUE CT, STE 201 AND 202, GREELEY, CO 80634-2562
(970) 672-4667
Mailing address
4025 RAWLINS ST, CHEYENNE, WY 82001-1900
(307) 426-4797

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MFTC.0014028
CO
103K00000X
Behavior Analyst
106H00000X
Marriage & Family Therapist
Primary
LMFT.0002235
CO

Other

Enumeration date
04/16/2014
Last updated
05/04/2023
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