Individual
HOLLY M JACKSON,
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
110 E MESCALERO RD, ROSWELL, NM 88201-6542
(575) 755-2272
(575) 622-3325
Mailing address
110 E MESCALERO RD, ROSWELL, NM 88201-6542
(575) 755-2272
(575) 622-3325
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/28/2023
Last updated
04/28/2023
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