Individual
LUCIANA (SHAWNA) JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
12110 CLAYTON RD, SAINT LOUIS, MO 63131-2516
(314) 643-8382
Mailing address
12110 CLAYTON RD, SAINT LOUIS, MO 63131-2516
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
2015007579
MO
Other
Enumeration date
09/15/2015
Last updated
09/15/2015
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