Individual
LARRY V JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
1111 UNIVERSITY AVE, DES MOINES, IA 50314-2329
(515) 697-7982
Mailing address
121 E LANE ST TRLR 2, WINTERSET, IA 50273-1772
(563) 447-7344
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001738
IA
Other
Enumeration date
04/15/2016
Last updated
12/28/2023
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