Jackson, Alysa Michele
Jackson, Alysa Michele is an sole proprietor health care provider with primary practice located at 3000 'J' Street, Federal Medical Center, Carswell, Fort Worth TX 76127. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jackson, Alysa Michele can be contacted via phone (817) 782-4002.Contact Information
Primary practice address
3000 'J' Street, Federal Medical Center, Carswell
Fort Worth TX 76127
Phone: (817) 782-4002
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 075695 | New York |
Profile Details
| NPI number | 1073571428 |
|---|---|
| LBN Legal business name | Jackson, Alysa Michele |
| Credentials | MSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 3rd, 2006 |
| Last updated | Oct 10th, 2016 - about 8 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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