Individual
TIM JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2402 HIGH STAR DR, GARLAND, TX 75041-3236
(214) 253-7309
Mailing address
2402 HIGH STAR DR, GARLAND, TX 75041-3236
(214) 253-7309
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13134
TX
Other
Enumeration date
07/22/2022
Last updated
07/22/2022
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