Individual
DR. WINNIE FONG JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2817 ROCK MERRITT AVE, FORT BRAGG, NC 28310-2540
(910) 907-6825
Mailing address
2817 ROCK MERRITT AVE, FORT BRAGG, NC 28310-5000
(910) 907-6825
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PSYA00208
DC
103TC0700X
Clinical Psychologist
0810007677
VA
103TC0700X
Clinical Psychologist
Primary
6345
NC
Other
Enumeration date
04/12/2018
Last updated
05/15/2025
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