person
Casiel Dominique Jackson, LAC
Mental Health Counselor in Mesa, Arizona
NPI 1487373130

Casiel Dominique Jackson is a Mental Health Counselor based in Maricopa, AZ and is specialized in Mental Health. Casiel Dominique Jackson practices in Mesa, AZ and has the professional credentials of LAC. The NPI Number for Casiel Dominique Jackson is 1487373130 and holds a License No. LAC-7258T (Arizona).

The current practice location address for Casiel Dominique Jackson is 1705 W Main St, Mesa, AZ and can be reached out via phone at 877-809-5092.

Location: 1705 W Main St, Mesa, AZ, 85139-7074
person
Provider Profile Details
NPI Number
1487373130
Provider Name
Casiel Dominique Jackson
Credential
LAC
Provider Entity Type
Individual
Gender
Female
Address
1705 W Main St, Mesa, AZ, 85139-7074
Phone Number
877-809-5092
Fax Number
Provider Enumeration Date
08/25/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1705 W Main St
City
State
Zip
85201-6920
Phone Number
877-809-5092
Fax Number
person
Provider Business Mailing Address Details
Address
1705 W Main St
City
State
Zip
85201-6920
Phone Number
877-809-5092
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LAC-7258T (Arizona)
Definition
Definition to come...
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