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1740767649
CHEVON JACKSON
PORT ST LUCIE, FL
NPI
1740767649
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: FL 10018)
Enumeration Date
2018-07-24
Last Update Date
2018-07-24
Business Address
MS. CHEVON JACKSON MSW
525 NW LAKE WHITNEY PL STE 102
PORT ST LUCIE, FL 34986-1605
Phone number: 772-337-8164
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Mailing Address
MS. CHEVON JACKSON MSW
516 OLIVE TREE CIR
GREENACRES, FL 33413-3052
Phone number: 954-326-7776
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