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1154440287
WILLYE DORETHEA JACKSON
LOS ANGELES, CA
NPI
1154440287
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA ASW23815)
Enumeration Date
2007-03-28
Last Update Date
2013-05-28
Business Address
Ms. WILLYE DORETHEA JACKSON MSW
439 W 97TH ST
LOS ANGELES, CA 90003-3968
Phone number: 323-754-2856
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Mailing Address
Ms. WILLYE DORETHEA JACKSON MSW
439 W 97TH ST
LOS ANGELES, CA 90003-3968
Phone number: 323-754-2856
Copy
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