Individual
MRS. JANIS O'NEIL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHP
Contact information
Practice address
3522 WEBSTER RD, BLUE RIDGE, VA 24064-1980
(540) 977-6300
(540) 977-9523
Mailing address
176 MCINTOSH RD, ROANOKE, VA 24019-8425
(540) 206-6412
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0730000220
VA
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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