Individual
MRS. DANNA LEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA388
MD
101YP2500X
Professional Counselor
Primary
LCI990
MD
Other
Enumeration date
08/09/2007
Last updated
08/18/2016
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