Individual
ALEXANDREA J JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
350 POPLAR DR, PETERSBURG, VA 23805-9367
(804) 733-6874
(804) 518-1341
Mailing address
350 POPLAR DR, PETERSBURG, VA 23805-9367
(804) 733-6874
(804) 518-1341
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701009711
VA
Other
Enumeration date
08/10/2020
Last updated
08/11/2020
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