Individual
JESSIE R JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9855 E IRVINGTON RD, UNIT #82, TUCSON, AZ 85730-5220
(520) 733-1165
(520) 733-1165
Mailing address
9855 E IRVINGTON RD, UNIT #82, TUCSON, AZ 85730-5220
(520) 733-1165
(520) 733-1165
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
3923
AZ
Other
Enumeration date
10/19/2006
Last updated
07/09/2007
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