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1144389917
EDWARD L JACKSON
SAINT LOUIS, MO
NPI
1144389917
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MO 002498)
Enumeration Date
2006-12-08
Last Update Date
2007-07-08
Business Address
Mr. EDWARD L JACKSON LPC
7750 CLAYTON RD SUITE 103
SAINT LOUIS, MO 63117-1353
Phone number: 314-647-7708
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Mailing Address
Mr. EDWARD L JACKSON LPC
3807 KEENELAND CT
FLORISSANT, MO 63034-3350
Phone number: 314-921-2893
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