Individual
CHERI KATHLEEN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1600 SUTTER PL, CLOVIS, NM 88101-4611
(575) 769-4490
(575) 935-0011
Mailing address
1910 S MAIN PL, PORTALES, NM 88130-7343
(575) 359-1848
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
M-06393
NM
Other
Enumeration date
12/05/2008
Last updated
12/05/2008
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