Individual
ANISE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2782
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2782
BOARD OF EXAMINERS IN COUNSELING
AL
Enumeration date
01/23/2008
Last updated
09/10/2010
Update your record
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