JACKSON LAKE

LITTLE ROCK, AR
NPI1720763717
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor Mental Health
(Licence: AR  A2305013)
Enumeration Date2023-06-19
Last Update Date2023-06-19
Business Address
JACKSON LAKE LAC
10020 N RODNEY PARHAM RD STE G
LITTLE ROCK, AR 72227-5588
Phone number: 501-831-4314
Mailing Address
JACKSON LAKE LAC
10020 N RODNEY PARHAM RD STE G
LITTLE ROCK, AR 72227-5588
Phone number:
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