Individual
DEBBIE LEA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
1101 JOHNSON AVE STE 2, MYRTLE BEACH, SC 29577-1893
(843) 477-0177
Mailing address
1101 JOHNSON AVE STE 2, MYRTLE BEACH, SC 29577-1893
(843) 477-0177
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0008164
OH
Other
Enumeration date
03/04/2010
Last updated
02/02/2016
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