Individual
T THERESA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT-BC
Contact information
Practice address
1412 OAK GROVE DR, ROSEVILLE, CA 95747-7352
(916) 782-3467
Mailing address
1412 OAK GROVE DR, ROSEVILLE, CA 95747-7352
(916) 782-3467
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
08720
CA
Other
Enumeration date
08/07/2013
Last updated
08/07/2013
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