Individual
DR. KIM JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3330 ARTIC BLVD STE 101, ANCHORAGE, AK 99503-4580
(907) 600-3425
Mailing address
2600 CORDOVA ST STE 101, ANCHORAGE, AK 99503-2745
(907) 279-9640
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
225400000X
Rehabilitation Practitioner
1044974
AK
Other
Enumeration date
11/23/2016
Last updated
09/26/2022
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