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Individual

MS. DEBBIE ANN JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MFT-I

Contact information

Practice address
6765 W CHARLESTON BLVD, STE. #110, LAS VEGAS, NV 89146-2003
(702) 884-0405
Mailing address
2840 SHAYLA BAY AVE, NORTH LAS VEGAS, NV 89086-1431
(702) 884-0405

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
01486-L
NV
106H00000X
Marriage & Family Therapist
Primary
M10274
NV

Other

Enumeration date
02/08/2013
Last updated
02/08/2013
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