Individual
LAUREN TRACY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
125 LASALLE RD STE 300, WEST HARTFORD, CT 06107-2311
(860) 916-5106
Mailing address
125 LASALLE RD STE 300, WEST HARTFORD, CT 06107-2311
(860) 916-5106
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/21/2022
Last updated
10/21/2022
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