Jackson, Shanta D

Jackson, Shanta D is an sole proprietor health care provider with primary practice located at 1636 N Hampton Rd Ste 101 , Desoto TX 75115-8600. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Jackson, Shanta D can be contacted via phone (469) 751-7796.

Contact Information

Primary practice address
1636 N Hampton Rd Ste 101 Desoto TX 75115-8600
Phone: (469) 751-7796
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 73107 Texas
Behavioral Health & Social Service Providers / Professional 101YP2500X 73107 Texas

Profile Details

NPI number 1003322827
LBN Legal business name Jackson, Shanta D
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 15th, 2017
Last updated Dec 15th, 2017 - about 9 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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