Individual provider · Type 1 NPI

Tedra Nikia Jackson

Mental Health Counselor · Dallas, TX

NPI number 1023130176 Active

Practice location

3330 S Lancaster Rd
Dallas, TX 75216-4531

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1023130176

Tedra Nikia Jackson's National Provider Identifier is 1023130176, issued on Apr 6, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Dallas, TX. The record was last updated on Jul 8, 2007.