Individual ProviderTamra Lee JacksonSocial WorkerBehavioral Health & Social Service ProvidersPractice Address1085 Maple St, Farmington, MO 63640-1955(573) 756-5353(314) 206-3700PECOS EnrollmentBased on the most recent information from CMS, provider Tamra Lee Jackson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:13 AM.Profile DetailsProvider ID1457076481Provider TypeIndividualFull NameJackson, Tamra LeeGenderFemaleSole ProprietorNoEnumeration Date10/12/2022Last Updated10/12/2022Contact InformationPractice LocationPractice Address1085 Maple St, Farmington, MO 63640-1955Phone(573) 756-5353Fax(573) 756-4557Mailing LocationMailing Address1430 Olive St Ste 400, Saint Louis, MO 63103-2303Phone(314) 206-3700FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer