Individual
MR. CASEY EDEN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLPC
Contact information
Practice address
10918 ELM AVE STE 102, KANSAS CITY, MO 64134-2284
(816) 767-4230
Mailing address
10918 ELM AVE, KANSAS CITY, MO 64134-4108
(816) 767-4230
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2017009204
MO
Other
Enumeration date
12/15/2017
Last updated
12/15/2017
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