Illya Jackson
Illya Jackson is a Marriage & Family Therapist in Ft Worth, Texas. Practices as a sole proprietor. Licensed in California.
- Licensed in
- CA
- In the registry since
- 2015
Practice location Address checks out
1518 Vaughn BlvdFt Worth, TX 76105-2307
Phone: (214) 515-2079
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Marriage & Family Therapist (primary) | Taxonomy 106H00000X · Licence IACCP0064 (CA) |
|---|
Record details
| NPI number | 1700269149 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 2, 2015 |
| Last updated in NPPES | July 2, 2015 |
| Mailing address | 1518 Vaughn Blvd, Ft Worth, TX 76105-2307 |
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