Individual
GINA LYNN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6542 NASHVILLE AVE, SAINT LOUIS, MO 63139-3427
(314) 884-8034
Mailing address
6542 NASHVILLE AVE, SAINT LOUIS, MO 63139-3427
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2025042242
MO
Other
Enumeration date
10/06/2025
Last updated
10/06/2025
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