Individual
KRYSTAL C JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
91 NORTHWEST DR, PLAINVILLE, CT 06062-1534
(860) 793-3500
Mailing address
1826 CORBIN AVE, NEW BRITAIN, CT 06053-2704
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/23/2008
Last updated
09/23/2008
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