Melanie Jackson
Counselor, Professional in San Antonio, TX. Individual provider (NPI-1).
NPI number1437726007
StatusActive
Last updated in NPPESJun 10, 2021
Details
- NPI
- 1437726007
- Entity type
- Individual (NPI-1)
- Name
- Melanie Jackson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 10, 2021
- Certification date
- Jun 10, 2021
- Last updated
- Jun 10, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 78395 | TX | Yes |
Practice location
1718 Salt Lick RdSan Antonio, TX 78232-4991
Phone 210-601-9537
Mailing address
1718 Salt Lick RdSan Antonio, TX 78232-4991
Phone 210-601-9537
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