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
Phone: (573) 778-4740
Fax: (573) 778-4156
Website:
Health care specialties
| Specialty | Code | License # | 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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