Individual
BENISHA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
10909 MEMORIAL HWY, TAMPA, FL 33615-2511
(813) 864-1353
(813) 443-5795
Mailing address
10909 MEMORIAL HWY, TAMPA, FL 33615-2511
(813) 864-1353
(813) 443-5795
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/15/2011
Last updated
04/26/2021
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