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1568174605
LAQUANDA JACKSON
COLUMBIA, SC
NPI
1568174605
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2022-12-20
Last Update Date
2022-12-20
Business Address
LAQUANDA JACKSON
2715 COLONIAL DR STE 200A
COLUMBIA, SC 29203-6818
Phone number: 803-898-4800
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Mailing Address
LAQUANDA JACKSON
213 SAGAMARE RD
COLUMBIA, SC 29229-9155
Phone number: 843-687-2669
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