Individual
MRS. ELIZABETH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-A
Contact information
Practice address
127 W ANTRIM DR, GREENVILLE, SC 29607-2505
(864) 239-4110
Mailing address
205 TUMBLEWEED TER, TAYLORS, SC 29687-5623
(803) 807-7345
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6927
SC
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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