Jackson, Tifarah
Jackson, Tifarah is an individual health care provider with primary practice located at 1815 Mediterranean Dr , Sycamore IL 60178-3144. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Jackson, Tifarah can be contacted via phone (630) 297-3617.Contact Information
Primary practice address
1815 Mediterranean Dr
Sycamore IL 60178-3144
Phone: (630) 297-3617
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 178.015091 | Illinois |
Profile Details
| NPI number | 1730709452 |
|---|---|
| LBN Legal business name | Jackson, Tifarah |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 22nd, 2020 |
| Last updated | Apr 22nd, 2020 - about 6 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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