Individual
NATOYA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC
Contact information
Practice address
121 S MAIN ST, KERNERSVILLE, NC 27284-2757
(336) 996-0631
(336) 996-5712
Mailing address
121 S MAIN ST, KERNERSVILLE, NC 27284-2757
(336) 996-0631
(336) 996-5712
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5317
NC
Other
Enumeration date
03/28/2007
Last updated
09/01/2011
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