Individual
MS. PENNY ANN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LADC
Contact information
Practice address
1240 W OWENS AVE STE 3, LAS VEGAS, NV 89106-2452
(702) 877-9850
(702) 877-9870
Mailing address
1240 W OWENS AVE STE 3, LAS VEGAS, NV 89106-2452
(702) 877-9850
(702) 877-9870
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NV
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/01/2010
Last updated
12/01/2010
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