Individual
PAMELA ANN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRADC
Contact information
Practice address
106 S INDEPENDENCE ST, HARRISONVILLE, MO 64701-2348
(816) 813-7533
(816) 813-7533
Mailing address
1706 NEW CASTLE DR, HARRISONVILLE, MO 64701-1364
(816) 813-7533
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
7780
MO
101YA0400X
Addiction (Substance Use Disorder) Counselor
9827
MO
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
12/14/2017
Last updated
06/16/2018
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