Individual provider · Type 1 NPI

Amani Ayisha Jackson

Professional Counselor · Fairbanks, AK

NPI number 1639742158 Active

Practice location

1825 Marika Rd
Fairbanks, AK 99709-5521

Mailing address

6631 E 9th Ave
Anchorage, AK 99504-1725

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X222527 (AK)
Community Health Worker 172V00000XNone listed

Professional Counselor: Definition to come...

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About NPI 1639742158

Amani Ayisha Jackson's National Provider Identifier is 1639742158, issued on Jul 22, 2021. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Fairbanks, AK. The record was last updated on May 9, 2024.