Individual
DENISE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW,ACSW,LCDC,BCD,
Contact information
Practice address
1901 VETERANS MEMORIAL DR, TEMPLE, TX 76504-7451
(180) 042-3111
Mailing address
PO BOX 3203, TEMPLE, TX 76505-3203
(254) 220-6801
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
10476
TX
1041C0700X
Clinical Social Worker
Primary
50146
TX
Other
Enumeration date
07/16/2006
Last updated
01/14/2010
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