Individual
JACQUELINE KAY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
201 SOUTH TYLER, DALLAS, TX 75208
(214) 942-5166
(214) 942-6006
Mailing address
201 SOUTH TYLER, DALLAS, TX 75208
(214) 942-5166
(214) 942-6006
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5461
TX
Other
Enumeration date
10/24/2008
Last updated
10/24/2008
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