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Individual

MR. LLOYD DALLAS JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.C.S.W.

Contact information

Practice address
1018 E NEW CIRCLE RD, LEXINGTON, KY 40505-4145
(859) 893-0146
Mailing address
2455 BARNES MILL RD, RICHMOND, KY 40475-9747
(859) 684-5669

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1878
KY

Other

Enumeration date
08/24/2006
Last updated
03/17/2008
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