Jackson, Tina

Jackson, Tina is an individual health care provider with primary practice located at 280 1St St Bldg 23 , Holloman Afb NM 88330-8273. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Jackson, Tina can be contacted via phone (575) 572-5676.

Contact Information

Primary practice address
280 1St St Bldg 23 Holloman Afb NM 88330-8273
Phone: (575) 572-5676
Fax: (575) 572-1523
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 4950 North Dakota

Profile Details

NPI number 1376968172
LBN Legal business name Jackson, Tina
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2014
Last updated Jul 26th, 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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