Individual
KATHERINE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1481 N ELISEO FELIX JR WAY, AVONDALE, AZ 85323-1216
(623) 932-7752
Mailing address
1481 N ELISEO FELIX JR WAY, AVONDALE, AZ 85323-1216
(623) 932-7752
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
4568043
AZ
Other
Enumeration date
08/04/2026
Last updated
08/04/2026
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