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1063171510
LORETTA PATRICE JACKSON
BRUNSWICK, GA
NPI
1063171510
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: GA CSW007274)
Enumeration Date
2021-12-13
Last Update Date
2021-12-13
Business Address
LORETTA PATRICE JACKSON LCSW
323 HONEYGAL RD
BRUNSWICK, GA 31525-5530
Phone number: 191-224-2279
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Mailing Address
LORETTA PATRICE JACKSON LCSW
323 HONEYGAL RD
BRUNSWICK, GA 31525-5530
Phone number: 191-224-2279
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