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1316576937
LAVONNE JACKSON
CLEARWATER, FL
NPI
1316576937
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL 18659)
Enumeration Date
2020-04-06
Last Update Date
2020-04-06
Business Address
LAVONNE JACKSON
622 S BETTY LN APT 2
CLEARWATER, FL 33756-6080
Phone number: 757-769-9056
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Mailing Address
LAVONNE JACKSON
PO BOX 7215
CLEARWATER, FL 33758-7215
Phone number: 757-769-9056
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