Dreatha Jean Jackson in Centralia - Professional
Dreatha Jean Jackson - NPI 1801963483
Dreatha Jean Jackson is a Professional in Centralia, Illinois. Dreatha Jean Jackson practices all healthcare services and medical treatments related to Professional. The NPI Number for Dreatha Jean Jackson is 1801963483. The last update date is 2020-03-26.
Dreatha Jean Jackson's current location address is 406 Linden Ave, Centralia, Illinois. You can contact this provider via phone number 6186239771. The mailing address for Dreatha Jean Jackson is 406 Linden Ave, Centralia, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Dreatha Jean Jackson |
|---|---|
| Address | 406 Linden Ave, Centralia, Illinois |
| Phone Number | 6186239771 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | MA, LPC, N |
NPI Number Detail
| NPI Number | 1801963483 |
|---|---|
| Provider Enumeration Date | 2006-11-29 |
| Last Updated Date | 2020-03-26 |
Provider Mailing Address Detail
| Address | 406 Linden Ave |
|---|---|
| City | Centralia |
| State | Illinois (IL) |
| Post Code | 628014329 |
| Phone Number | 6186239771 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Professional |
|---|---|
| Taxonomy | 101Yp2500X |
| Licence No | 6130 |
|
Definition: A general counselor who helps people with personal, social, educational, and career issues. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 495864829 | MO | -- | |
| 495864803 | MO | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Dreatha Jean Jackson?
The Dreatha Jean Jackson has been issued the NPI (National Provider Identifier) 1801963483 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Can you provide the Dreatha Jean Jackson's physical address?
The Dreatha Jean Jackson is physically located at 406 Linden Ave, in the city of Centralia, IL, with the postal code 628014329.
What is Dreatha Jean Jackson's specialized field of practice, and what is the corresponding taxonomy classification code?
The Dreatha Jean Jackson's area of specialization is Professional, and the corresponding taxonomy code that categorizes this field of practice is 101Yp2500X.
When did the Dreatha Jean Jackson receive its 1801963483?
The Dreatha Jean Jackson was issued its 1801963483 on 2006-11-29, which is the date when the organization was assigned this unique identifier.
When was the Dreatha Jean Jackson's information last updated?
The Dreatha Jean Jackson's information was last updated on 2020-03-26.