Individual
MRS. DYNASTY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NBHWC, LBSW
Contact information
Practice address
110 12TH ST N, BIRMINGHAM, AL 35203-1537
(855) 255-2362
Mailing address
110 12TH ST N, BIRMINGHAM, AL 35203-1537
(855) 255-2362
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
3167787
AL
Other
Enumeration date
06/20/2022
Last updated
06/20/2022
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