Individual
MRS. KATE SOREL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
136 PORT DR, MADISON, TN 37115-3421
(925) 683-3732
Mailing address
136 PORT DR, MADISON, TN 37115-3421
(925) 683-3732
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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