Individual
ANGELA MARIA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3903 HARRISON BLVD STE 300, OGDEN, UT 84403-2362
(801) 387-5600
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 387-5600
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
359140-6004
UT
Other
Enumeration date
07/21/2006
Last updated
05/21/2019
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