| Doctor Name: | MRS. JENNIFER JO-JIVIDEN JACKSON |
| NPI Number: | 1194055087 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LIMHP, LMHP, LPC |
| License Number: | 8988 |
| Business Practice Address: | 917 W 21st St South Sioux City, NE - 687762652 |
| Business Phone Number: | 4024943337 |
| Business Fax Number: | 4024943356 |
| Mailing Address: | 917 W 21st St, Po Box 355 SOUTH SIOUX CITY |
| State: | NE |
| Postal Code: | 687762652 |
| Phone Number: | 4024943337 |
| Fax Number: | 4024943356 |
| NPI Enumeration Date: | 12/28/2009 |
| NPI Last Update Date: | 01/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 8988 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NE |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |