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Individual

DIXIE L JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
800 E BLACKHAWK AVE, PRAIRIE DU CHIEN, WI 53821-1698
(608) 326-0808
(608) 326-0810
Mailing address
800 E BLACKHAWK AVE, PRAIRIE DU CHIEN, WI 53821-1698
(608) 326-0808
(608) 326-0810

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
3842
WI
101YP2500X
Professional Counselor
Primary
3842
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43713500
WI
Enumeration date
03/31/2008
Last updated
03/31/2008
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