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1336332238
LATRELLE JACKSON
RICHMOND, VA
NPI
1336332238
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: VA 0810003414)
Enumeration Date
2007-08-23
Last Update Date
2008-11-11
Business Address
-- LATRELLE JACKSON PhD
9702 GAYTON RD #181
RICHMOND, VA 23238-4907
Phone number: 804-741-7500
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Mailing Address
-- LATRELLE JACKSON PhD
9702 GAYTON RD #181
RICHMOND, VA 23238-4907
Phone number: 804-741-7500
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