Individual
RALISSA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1231 N 29TH ST, BILLINGS, MT 59101-0147
(406) 248-3175
Mailing address
616 N 16TH ST, BILLINGS, MT 59101-0416
(406) 707-4479
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
70320
MT
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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