Individual provider · Type 1 NPI

Tasha Jackson, LLPC

Professional Counselor · Southgate, MI

NPI number 1205481264 Active

Practice location

13305 Reeck Ct
Southgate, MI 48195-3197

Mailing address

6549 Town Center Dr Ste A
Clarkston, MI 48346-4824

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X6401016482 (MI)

Professional Counselor: Definition to come...

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About NPI 1205481264

Tasha Jackson, LLPC's National Provider Identifier is 1205481264, issued on Aug 7, 2019. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Southgate, MI. The record was last updated on Aug 7, 2019.