Individual
STACY HARKINS JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1812 WILMER AVE STE A, ANNISTON, AL 36201-3830
(256) 624-7045
Mailing address
609 DOUGLAS ST, OXFORD, AL 36203-3705
(256) 624-7045
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4288C
AL
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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