Individual
JORDAN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5153 WEAR RD APT 1, GRAND BAY, AL 36541-3223
(601) 434-0616
Mailing address
5153 WEAR RD, GRAND BAY, AL 36541-3223
(601) 434-0616
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3309
MS
Other
Enumeration date
07/07/2025
Last updated
07/07/2025
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