Individual
TERRI JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1104 ALLURE DR, LAS VEGAS, NV 89128-2095
(702) 561-2725
Mailing address
PO BOX 753394, LAS VEGAS, NV 89136-3394
(702) 100-0000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CI0335
NV
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
10/21/2010
Last updated
01/21/2022
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