Individual
CHEYENNE L JACKSON I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
380 FREEVILLE RD, FREEVILLE, NY 13068-9684
(607) 844-6483
Mailing address
1290 ROCKLEDGE BLVD FL 32955, ROCKLEDGE, FL 32955-2712
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YS0200X
School Counselor
Primary
—
—
Other
Enumeration date
07/15/2020
Last updated
06/01/2021
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