Individual
AMORE NICHOLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6120 BROOKSHIRE BLVD STE W, CHARLOTTE, NC 28216-3300
(980) 251-5899
Mailing address
1962 HARTFORD DR, GASTONIA, NC 28052-6050
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
—
—
183700000X
Pharmacy Technician
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
08/07/2019
Last updated
12/12/2023
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