Individual
NATHAN EDWARD JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4101 WOOLWORTH AVE, OMAHA, NE 68105-1850
(800) 451-5796
Mailing address
507 GASLIGHT LN APT 3, BELLEVUE, NE 68005-2663
(402) 889-7284
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
12473
NE
104100000X
Social Worker
Primary
7574
NE
Other
Enumeration date
02/26/2021
Last updated
02/26/2021
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