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Individual

MR. TIMOTHY G JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MMFT, LMFT-A

Contact information

Practice address
128 MILLPORT CIR STE 200, GREENVILLE, SC 29607-5573
(864) 214-6257
Mailing address
128 MILLPORT CIR STE 200, GREENVILLE, SC 29607-5573
(864) 214-6257

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
8004
SC

Other

Enumeration date
07/10/2023
Last updated
07/10/2023
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