Individual
KATHLEEN A JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1101 MEDICAL ARTS AVE NE BLDG 3, ALBUQUERQUE, NM 87102-2706
(505) 842-5300
(505) 765-1100
Mailing address
1101 MEDICAL ARTS AVE NE BLDG 3, ALBUQUERQUE, NM 87102-2706
(505) 842-5300
(505) 765-1100
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1153
NM
Other
Enumeration date
01/05/2007
Last updated
07/08/2007
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