Individual
CHRISTINE B JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
S.L.P.
Contact information
Practice address
6125 E BELKNAP ST, HALTOM CITY, TX 76117-4296
(817) 547-5700
Mailing address
6125 E BELKNAP ST, HALTOM CITY, TX 76117-4296
(817) 547-5700
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
16509
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005202901
—
TX
Enumeration date
12/18/2006
Last updated
04/21/2022
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