Individual
MS. LYLE HENDRICKS JACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1807A E MAIN ST, EASLEY, SC 29640-3841
(864) 442-7482
(864) 306-7977
Mailing address
1807A E MAIN ST, EASLEY, SC 29640-3841
(864) 442-7482
(864) 306-7977
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5292
SC
Other
Enumeration date
02/16/2009
Last updated
02/16/2009
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