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1639552094
SHANA JACKSON
ROANOKE, VA
NPI
1639552094
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: VA 0904009062)
Enumeration Date
2015-07-02
Last Update Date
2017-05-03
Business Address
SHANA JACKSON LCSW
3517 BRANDON AVE SW
ROANOKE, VA 24018-1523
Phone number: 540-981-1102
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Mailing Address
SHANA JACKSON LCSW
3517 BRANDON AVE SW
ROANOKE, VA 24018-1523
Phone number: 540-981-1102
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