Individual
MIRIAM DENISE JACKSON-HAMILTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
159 PARKWAY AVE, ROLLING FORK, MS 39159-5112
(662) 907-1906
Mailing address
159 PARKWAY AVE, ROLLING FORK, MS 39159-5112
(662) 907-1906
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2303
MS
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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