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Individual

ALEXIS JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
880 BROADSTONE WAY APT 308, ALTAMONTE SPRINGS, FL 32714-1650
(919) 396-3178
Mailing address
2290 N RONALD REAGAN BLVD STE 116, LONGWOOD, FL 32750-3534
(407) 215-0095

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
04/12/2022
Last updated
04/12/2022
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