Individual
LINDA NATASHA RENE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2715 BULLIS AVE, GULFPORT, MS 39501-5233
(228) 220-4226
Mailing address
2715 BULLIS AVE, GULFPORT, MS 39501-5233
(706) 845-4054
(228) 220-4226
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3118
MS
Other
Enumeration date
03/28/2018
Last updated
07/22/2024
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