Individual
ROSHAWNA T JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPMHP, LPADC
Contact information
Practice address
7215 ONTARIO ST, OMAHA, NE 68124-3574
(531) 999-7120
Mailing address
1650 S TOPAZ WAY, MERIDIAN, ID 83642-4474
(208) 705-6050
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/14/2014
Last updated
04/12/2023
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