| NPI | 1518668342 |
|---|---|
| Professional Name | LACIE DEA JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE P-2425) |
| Enumeration Date | 2023-03-17 |
| Last Update Date | 2026-05-18 |