Individual
EBONY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QBHP
Contact information
Practice address
3604 CENTRAL AVE STE C, HOT SPRINGS, AR 71913-6458
(501) 623-9220
(501) 923-9227
Mailing address
10025 W MARKHAM ST STE 210, LITTLE ROCK, AR 72205-2178
(501) 663-5473
(501) 801-1816
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/14/2024
Last updated
05/14/2024
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