Individual
HAILEY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
2900 ADAMS ST STE A410, RIVERSIDE, CA 92504-8306
(951) 351-4418
Mailing address
2900 ADAMS ST STE A410, RIVERSIDE, CA 92504-8306
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8794
CA
Other
Enumeration date
11/13/2020
Last updated
11/13/2020
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