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Individual

MRS. AYANA JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PLPC

Contact information

Practice address
11042 MANCHESTER RD, KIRKWOOD, MO 63122-1244
(314) 527-0554
Mailing address
3730 HUMPHREY ST APT A, SAINT LOUIS, MO 63116-4824
(314) 922-5563

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
04/02/2020
Last updated
04/02/2020
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