Individual
BRIDGET LASHUWN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RMHCI
Contact information
Practice address
416 SW LAWLER AVE, PORT ST LUCIE, FL 34953-3882
(754) 366-4255
Mailing address
416 SW LAWLER AVE, PORT ST LUCIE, FL 34953-3882
(754) 366-4255
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/20/2018
Last updated
07/20/2018
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