Organization
JACKSON PROFESSIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTYN JACKSON M.S. (LMFT)
(859) 475-3482
Entity
Organization
Contact information
Practice address
1827 EASTERN PKWY, LOUISVILLE, KY 40204-1416
(859) 475-3482
Mailing address
1827 EASTERN PKWY, LOUISVILLE, KY 40204-1416
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MFTMFT00220805
KY
Other
Enumeration date
03/25/2016
Last updated
03/25/2016
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