Individual
CHRISTIAN NICOLE RECORD-JACKSON
Active
Individual
CHRISTIAN NICOLE RECORD-JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY 0810008030
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
105956
CA
103TC0700X
Clinical Psychologist
Primary
0810008030
VA
Other
Enumeration date
04/24/2018
Last updated
05/18/2026
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