Antoinette Jackson

NPI #1225336514 in Murray, Utah

Provider Information

NPI Number: 1225336514
Entity Type: Individual
Name: Antoinette Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Mar 10, 2011
Last Updated: Mar 10, 2011

Practice Location

Address: 5965 S 900 E
City: Murray
State: Utah
ZIP Code: 84121-1720
Phone: (801) 263-7100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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