Jackson, Sandra G.
Jackson, Sandra G. is an individual health care provider with primary practice located at 1900 E. Tenth Street , Alamogordo NM 88310. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Jackson, Sandra G. can be contacted via phone (575) 437-7404.Contact Information
Primary practice address
1900 E. Tenth Street
Alamogordo NM 88310
Phone: (575) 437-7404
Fax: (575) 439-2860
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 0112141 | New Mexico |
Profile Details
| NPI number | 1366459778 |
|---|---|
| LBN Legal business name | Jackson, Sandra G. |
| Credentials | LPCC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 1st, 2006 |
| Last updated | Mar 29th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366459778 | NPPES |
| New Mexico | MEDICAID | 94206708 | |
| New Mexico | MEDICAID | 18677037 |
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