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Individual

MS. JALESA DENISE NICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ED.S

Contact information

Practice address
108 SCR 581B, RALEIGH, MS 39153-5438
(601) 577-2599
(601) 952-4398
Mailing address
108 SCR 581B, RALEIGH, MS 39153-5438
(601) 577-2599
(601) 952-4398

Taxonomy

Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
216761
MS
103TC1900X
Counseling Psychologist
216761
MS

Other

Enumeration date
05/24/2022
Last updated
05/24/2022
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