| NPI | 1134466030 |
|---|---|
| Former Name | SHERRILL TAREN JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 37787) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2018-03-17 |