Individual
MS. SHANTYA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
601 N PECOS RD, LAS VEGAS, NV 89101-2408
(808) 205-6622
Mailing address
601 N PECOS RD, LAS VEGAS, NV 89101-2408
(808) 205-6622
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10483-C
NV
Other
Enumeration date
06/14/2020
Last updated
09/20/2024
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