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Tiffany Nicole Jackson
Mental Health Counselor in Lutz, Florida
NPI 1164950630

Tiffany Nicole Jackson is a Mental Health Counselor based in Tampa, FL and is specialized in Mental Health. Tiffany Nicole Jackson practices in Lutz, FL. The NPI Number for Tiffany Nicole Jackson is 1164950630 and holds a License No. MH16981 (Florida).

The current practice location address for Tiffany Nicole Jackson is 21808 State Road 54, Lutz, FL and can be reached out via phone at 813-428-6100.

Location: 21808 State Road 54, Lutz, FL, 33646-0104
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164950630
Provider Name
Tiffany Nicole Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
21808 State Road 54, Lutz, FL, 33646-0104
Phone Number
813-428-6100
Fax Number
Provider Enumeration Date
05/30/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
21808 State Road 54
City
Lutz
State
Florida
Zip
33549-6923
Phone Number
813-428-6100
Fax Number
person
Provider Business Mailing Address Details
Address
21808 State Road 54
City
Lutz
State
Florida
Zip
33549-6923
Phone Number
813-428-6100
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
MH16981 (Florida)
Definition
Definition to come...
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