Doctor Name: | MS. ALICIA L. JACKSON |
NPI Number: | 1801084066 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | |
Business Practice Address: | 445 3rd Ave Sw Albany, OR - 973212272 |
Business Phone Number: | 5419673866 |
Business Fax Number: | 5419266271 |
Mailing Address: | 445 3rd Ave Sw, P.o. Box 100 ALBANY |
State: | OR |
Postal Code: | 973212272 |
Phone Number: | 5419673866 |
Fax Number: | 5419266271 |
NPI Enumeration Date: | 10/11/2007 |
NPI Last Update Date: | 10/11/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |