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NPI Profile for KRISTI JACKSON in MAYKING, KY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction (Substance Use Disorder) |
101YA0400X |
| NPI # | 1427364058 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/20/2010 | |
| Last updated | 11/19/2010 - About 16 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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KRISTI JACKSON
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KRISTI JACKSON