Most Relevant Information
Provider Data
| NPI Number: | 1003504432 |
| Provider Name: | COURTNEY JACKSON MS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/25/2023 |
| Last Updated: | 04/25/2023 |
Provider Practice Location
4045 S 180TH DR
GOODYEAR
AZ
853386444
Practice Location Phone/Fax
| Phone: | 4809379546 |
| Fax: |
Provider Mailing Location
4045 S 180TH DR
GOODYEAR
AZ
853386444
Provider Mailing Phone/Fax
| Phone: | 4809379546 |
| Fax: |