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1669186490
LARA JEANNE JACKSON
VISTA, CA
NPI
1669186490
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: CA 360881)
Enumeration Date
2023-01-06
Last Update Date
2023-01-06
Business Address
LARA JEANNE JACKSON LMFT
1938 INTREPID WAY
VISTA, CA 92081-7037
Phone number: 760-419-6556
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Mailing Address
LARA JEANNE JACKSON LMFT
1938 INTREPID WAY
VISTA, CA 92081-7037
Phone number: 760-419-6556
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