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Patrick Dior Jackson
School Counselor in Louisville, Kentucky
NPI 1871141457

Patrick Dior Jackson is a School Counselor based in Jeffersonvlle, KY and is specialized in School. Patrick Dior Jackson practices in Louisville, KY. The NPI Number for Patrick Dior Jackson is 1871141457 and holds a License No. 201114318 (Kentucky).

The current practice location address for Patrick Dior Jackson is 5111 S 3Rd St, Louisville, KY and can be reached out via phone at 502-690-1511.

Location: 5111 S 3Rd St, Louisville, KY, 47130-4220
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871141457
Provider Name
Patrick Dior Jackson
Credential
Provider Entity Type
Individual
Gender
Male
Address
5111 S 3Rd St, Louisville, KY, 47130-4220
Phone Number
502-690-1511
Fax Number
Provider Enumeration Date
08/28/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5111 S 3Rd St
City
Louisville
State
Kentucky
Zip
40214-2601
Phone Number
502-690-1511
Fax Number
person
Provider Business Mailing Address Details
Address
5111 S 3Rd St
City
Louisville
State
Kentucky
Zip
40214-2601
Phone Number
502-690-1511
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
School
Taxonomy
101YS0200X
License No.
201114318 (Kentucky)
Definition
Definition to come...
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