Jackson, Tierra
Jackson, Tierra is an sole proprietor health care provider with primary practice located at 4680 Lipscomb St Ne Suite 10A, Palm Bay FL 32905-2984. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Jackson, Tierra can be contacted via phone (321) 433-3570.Contact Information
Primary practice address
4680 Lipscomb St Ne Suite 10A
Palm Bay FL 32905-2984
Phone: (321) 433-3570
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | IMT2200 | Florida |
Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 9096A | North Carolina |
Behavioral Health & Social Service Providers / Professional | 101YP2500X | A10704 | North Carolina |
Profile Details
NPI number | 1225440548 |
---|---|
LBN Legal business name | Jackson, Tierra |
Credentials | LPCA, LMFTA, RMFTI |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | May 21st, 2014 |
Last updated | Dec 17th, 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.
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