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1356774723
DANITA A JACKSON
WAUWATOSA, WI
NPI
1356774723
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: WI 1854-226)
Enumeration Date
2013-08-20
Last Update Date
2014-03-22
Business Address
-- DANITA A JACKSON LPC-IT
10045 W LISBON AVE
WAUWATOSA, WI 53222-2446
Phone number: 414-358-7999
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Mailing Address
-- DANITA A JACKSON LPC-IT
10045 W LISBON AVE
WAUWATOSA, WI 53222-2446
Phone number: 414-358-7999
Copy
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