Jackson, Kimberly

Jackson, Kimberly is an individual health care provider with primary practice located at 11960 Westline Industrial Dr Ste 201, Saint Louis MO 63146-3209. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Jackson, Kimberly can be contacted via phone (866) 433-9555.

Contact Information

Primary practice address
11960 Westline Industrial Dr Ste 201 Saint Louis MO 63146-3209
Phone: (866) 433-9555
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 101YS0200X 197095 Missouri

Profile Details

NPI number 1811449275
LBN Legal business name Jackson, Kimberly
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2016
Last updated Nov 1st, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1811449275 NPPES
Missouri Other 197095 EDUCATOR ID

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