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1043934227
LAKETA SHA-RON JACKSON
FORT WAYNE, IN
NPI
1043934227
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
Enumeration Date
2022-09-30
Last Update Date
2022-09-30
Business Address
LAKETA SHA-RON JACKSON MFT
6202 CONSTITUTION DR STE D
FORT WAYNE, IN 46804-1583
Phone number: 260-432-0066
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Mailing Address
LAKETA SHA-RON JACKSON MFT
6202 CONSTITUTION DR STE D
FORT WAYNE, IN 46804-1583
Phone number: 260-432-0066
Copy
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