Individual
MRS. ANDREA LATRELL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
10610 N 30TH ST, APT. 46H, TAMPA, FL 33612-6458
(813) 997-6288
Mailing address
10610 N 30TH ST, APT. 46H, TAMPA, FL 33612-6458
(813) 997-6288
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/04/2013
Last updated
09/08/2015
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