Individual
AUBREY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2414 BULL ST, COLUMBIA, SC 29201-1906
(803) 898-8600
Mailing address
2414 BULL ST, COLUMBIA, SC 29201-1906
(803) 898-8600
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/10/2017
Last updated
02/25/2021
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