Individual
MRS. CHISSY LYNN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2580 W CAMP WISDOM RD, SUITE 100 #135, GRAND PRAIRIE, TX 75052-3088
(817) 688-6264
Mailing address
2580 W CAMP WISDOM RD, SUITE 100 #135, GRAND PRAIRIE, TX 75052-3088
(817) 688-6264
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34044
TX
Other
Enumeration date
01/02/2013
Last updated
01/02/2013
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