Individual
JASON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
739 THIMBLE SHOALS BLVD, NEWPORT NEWS, VA 23606-3562
(757) 816-7842
Mailing address
6020 BLUFFWOOD CT, NORTH CHESTERFIELD, VA 23234-3209
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1584
VA
Other
Enumeration date
02/24/2014
Last updated
02/24/2014
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