Individual
VALERIE DARICE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH D
Contact information
Practice address
3730 KIRBY DR STE 904, HOUSTON, TX 77098-3994
(832) 484-2635
(832) 202-2479
Mailing address
3730 KIRBY DR STE 904, HOUSTON, TX 77098-3994
(832) 484-2635
(832) 202-2479
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
36604
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162342304
—
TX
Enumeration date
04/05/2012
Last updated
04/06/2018
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