Individual
CORBY RYAN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11300 N CENTRAL EXPY STE 400, DALLAS, TX 75243-6712
(844) 824-8775
(281) 648-2200
Mailing address
1225 RICHARDS ST, JOLIET, IL 60433-2745
(708) 768-2144
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180.015589
IL
101YP2500X
Professional Counselor
Primary
95036
TX
Other
Enumeration date
03/10/2016
Last updated
09/10/2024
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