Individual
MR. ROBERT JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
115 ROCKWOOD LN, HAZARD, KY 41701-9415
(606) 436-5761
(606) 436-5797
Mailing address
115 ROCKWOOD LN, HAZARD, KY 41701-9415
(606) 436-5761
(606) 436-5797
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0442
KY
Other
Enumeration date
08/30/2006
Last updated
11/22/2010
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