Individual
MRS. AMANDA MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24 GOLDLEAF FALLS AVE, NORTH LAS VEGAS, NV 89031-2957
(202) 909-5016
Mailing address
24 GOLDLEAF FALLS AVE, NORTH LAS VEGAS, NV 89031-2957
(202) 909-5016
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
11782-C
NV
Other
Enumeration date
10/06/2015
Last updated
04/02/2025
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