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1750710174
LATONYA DEMETRIA JACKSON
COLUMBIA, SC
NPI
1750710174
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Former Name
LATONYA DETERIMA HARRIS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-11-06
Last Update Date
2013-11-06
Business Address
Mrs. LATONYA DEMETRIA JACKSON CAC II
2711 COLONIAL DR
COLUMBIA, SC 29203-6818
Phone number: 803-726-9300
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Mailing Address
Mrs. LATONYA DEMETRIA JACKSON CAC II
2711 COLONIAL DR
COLUMBIA, SC 29203-6818
Phone number: 803-726-9300
Copy
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