Individual
KRISTI JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3367 HWY 119 N, MAYKING, KY 41837
(606) 633-4439
Mailing address
115 ROCKWOOD LN, HAZARD, KY 41701-9415
(606) 436-5761
(606) 436-5797
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0990
KY
Other
Enumeration date
08/20/2010
Last updated
11/19/2010
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