Mrs. Sandra Jackson LMHC
Mental Health Counselor in St Augustine, FL(View on Map)
Full Name
Mrs. Sandra Jackson LMHC
NPI Number
1356330765
NPI Type
Individual Provider
Gender
Female
Enumeration Date
10/18/2005
Specialties
(Taxonomies)Licenses
State
Florida
License Number
MH8391
Contact
Information
Purpose
Mailing
Location
Address
1955 US HIGHWAY 1 S
1955 US HIGHWAY 1 S
City
St Augustine
St Augustine
State
FL
FL
Postal Code
32086-3708
32086-3708
Country
US
US
Telephone Number
(904) 209-6222
(904) 209-6222
Identifiers
Identifier
767122900
Z089A
Identifier State
FL
FL
Identifier Issuer
Unknown
BCBS
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/24/2012