Individual
AMANDA LEIGH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17800 US HIGHWAY 18, APPLE VALLEY, CA 92307-1221
(760) 946-8200
(760) 242-1425
Mailing address
17800 US HIGHWAY 18, APPLE VALLEY, CA 92307-1221
(760) 946-8200
(760) 242-1425
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
11586
CA
Other
Enumeration date
07/14/2015
Last updated
04/10/2023
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