Individual
VERONICA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
655 RIVERSIDE DR, MEMPHIS, TN 38103-4600
(901) 233-8866
Mailing address
655 RIVERSIDE DR, MEMPHIS, TN 38103-4600
(901) 233-8866
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CSW0000003395
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSW0000003395
STATE LIC
TN
Enumeration date
07/18/2006
Last updated
07/08/2007
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