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1922564012
CHARMAYNE LATRIECE JACKSON
GAINESVILLE, FL
NPI
1922564012
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL MH22183)
Additional Taxonomies
101Y00000X Counselor
Enumeration Date
2019-02-14
Last Update Date
2023-05-09
Business Address
CHARMAYNE LATRIECE JACKSON MS, LMHC
2601 NW 23RD BLVD APT 243
GAINESVILLE, FL 32605-5958
Phone number: 317-698-2713
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Mailing Address
CHARMAYNE LATRIECE JACKSON MS, LMHC
2701 NW 23RD BLVD APT B20
GAINESVILLE, FL 32605-2926
Phone number: 317-698-2713
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