Individual
SELENA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1901 E 1ST ST, NEWTON, KS 67114-5010
(316) 284-6400
Mailing address
2931 N GOVERNEOUR ST APT 306, WICHITA, KS 67226-1783
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2781
KS
Other
Enumeration date
07/19/2017
Last updated
07/19/2017
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