Tracie R Jackson, PRS

NPI #1982494522 in Covington, Kentucky

Provider Information

NPI Number: 1982494522
Entity Type: Individual
Name: Tracie R Jackson, PRS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Credential: PRS
Enumeration Date: May 7, 2025
Last Updated: May 7, 2025

Practice Location

Address: 9186 BLUERIDGE DRIVE
City: Covington
State: Kentucky
ZIP Code: 41017
Phone: (859) 912-5618

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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