Vivian Jackson's National Provider Identifier (NPI) Details
Vivian Jackson, LMHC
NPI: 1922210210
Enumeration Date: 2007-05-07
Last updated: 2022-03-23
Sole Proprietor: NO
Status: active
Postal Address: 945 GRAND ST, STARKE, FL
Phone: 352-374-5600
Primary Practice Address: 4300 SW 13TH ST, GAINESVILLE, FL
Practice's phone: 352-374-5600