Individual provider · Type 1 NPI

Kristie Jackson

Mental Health Counselor · Vidalia, LA

NPI number 1639629454 Active

Practice location

1644 Carter St, Suite 2
Vidalia, LA 71373-3143

Call (318) 414-3065 Map

Fax (318) 414-3067

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

10 other providers at this address

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About NPI 1639629454

Kristie Jackson's National Provider Identifier is 1639629454, issued on Oct 4, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Vidalia, LA. The record was last updated on Oct 4, 2016.