Individual
KIMBERLY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT-BC
Contact information
Practice address
121 KOEPPE DR, SEQUIM, WA 98382-9489
(408) 540-4195
Mailing address
121 KOEPPE DR, SEQUIM, WA 98382-9489
(408) 540-4195
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
—
—
Other
Enumeration date
04/21/2020
Last updated
04/21/2020
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