Individual
MS. LISA R JACKERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., M.T.-B.C.
Contact information
Practice address
301 ARGONNE AVE, LONG BEACH, CA 90814-3110
(562) 716-0076
Mailing address
PO BOX 3136, LONG BEACH, CA 90803-0136
(562) 716-0076
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
CERT # 03815
—
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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