Individual
JACQUELINE R JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3100 LEBRON RD, 3100 LEBRON RD, MONTGOMERY, AL 36106
(334) 235-2274
Mailing address
3100 LEBRON RD, 3100 LEBRON RD, MONTGOMERY, AL 36106
(334) 235-2274
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
ALCO4539
AL
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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