Jackson, Sandra W.

Jackson, Sandra W. is an sole proprietor health care provider with primary practice located at 1500 N Westwood Blvd , Poplar Bluff MO 63901-3318. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jackson, Sandra W. can be contacted via phone (573) 778-4740.

Contact Information

Primary practice address
1500 N Westwood Blvd Poplar Bluff MO 63901-3318
Fax: (573) 778-4156
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 44SC01019000 New Jersey

Profile Details

NPI number 1205035003
LBN Legal business name Jackson, Sandra W.
Credentials ED.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 12th, 2007
Last updated Jul 12th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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