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Individual

ALLISON JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCP

Contact information

Practice address
6440 NIEMAN RD, SHAWNEE, KS 66203-3326
(913) 826-4200
(913) 826-1589
Mailing address
6000 LAMAR AVE STE 130, MISSION, KS 66202-3299
(913) 826-4200
(913) 826-1589

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCP 1471
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201102500A
KS
Enumeration date
09/15/2014
Last updated
04/18/2019
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