Jackson, Shelby Renee

Jackson, Shelby Renee is an individual health care provider with primary practice located at 1836 Victoria Ln , Charleston IL 61920-2964. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Jackson, Shelby Renee can be contacted via phone (217) 508-8080.

Contact Information

Primary practice address
1836 Victoria Ln Charleston IL 61920-2964
Phone: (217) 508-8080
Fax: (217) 512-2288
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1285363614
LBN Legal business name Jackson, Shelby Renee
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2022
Last updated Jun 13th, 2022 - about 4 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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