Individual
TAMARA L JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1250 W WASHINGTON ST, TEMPE, AZ 85288-1697
(480) 200-4929
Mailing address
42586 W MICHAELS DR, MARICOPA, AZ 85138-9317
(480) 200-4929
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-21664
AZ
Other
Enumeration date
02/08/2024
Last updated
02/08/2024
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