Individual
KIM E JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFTA
Contact information
Practice address
1337 FOREST DR, LOUISVILLE, KY 40219-1418
(502) 708-2060
Mailing address
1337 FOREST DR, LOUISVILLE, KY 40219-1418
(502) 708-2060
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2013-012
KY
Other
Enumeration date
04/10/2014
Last updated
04/10/2014
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