Individual
JESSICA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1955 N VALLEY DR, LAS CRUCES, NM 88007-5154
(575) 523-2772
(575) 524-2993
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
38397
TX
Other
Enumeration date
12/23/2015
Last updated
01/22/2020
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