Individual
MR. RICKIE FREDERICK JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S. ED., LPC, CADC
Contact information
Practice address
349 N MCKEAN ST, BUTLER, PA 16001-4928
(412) 366-1300
(724) 282-2406
Mailing address
161 RICHARD DR, GLENSHAW, PA 15116-1229
(412) 977-6657
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PC005527
PA
Other
Enumeration date
07/24/2010
Last updated
05/03/2017
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