Individual
REGINA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3103 BLACKISTON MILL RD, NEW ALBANY, IN 47150-9536
(812) 590-7160
Mailing address
3103 BLACKISTON MILL RD, NEW ALBANY, IN 47150-9536
(812) 590-7160
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88001003A
IN
Other
Enumeration date
01/31/2020
Last updated
11/27/2023
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