| Doctor Name: | MRS. ALYSA MICHELE JACKSON |
| NPI Number: | 1073571428 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | 075695 |
| Business Practice Address: | 761st Tank Battallion Rd Bldg 2255 Crdamc Department Of Social Work Fort Hood, TX - 76544 |
| Business Phone Number: | 2542886474 |
| Business Fax Number: | |
| Mailing Address: | 215 Lottie Ln, HARKER HEIGHTS |
| State: | TX |
| Postal Code: | 765487472 |
| Phone Number: | 2548330663 |
| Fax Number: | |
| NPI Enumeration Date: | 05/03/2006 |
| NPI Last Update Date: | 07/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 075695 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |