Tina Jackson, LCSW
NPI #1376968172 in Holloman Afb, New Mexico
Provider Information
- NPI Number
- 1376968172
- Entity Type
- Individual
- Name
- Tina Jackson, LCSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker
- Credential
- LCSW
- Enumeration Date
- Mar 3, 2014
- Last Updated
- Jul 26, 2022
Practice Location
- Address
- 280 1ST ST BLDG 23
- City
- Holloman Afb
- State
- New Mexico
- ZIP Code
- 88330-8273
- Phone
- (575) 572-5676
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker |
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