Individual
LAURA M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
7090 COVENANT WOODS DR, MECHANICSVILLE, VA 23111-7025
(804) 569-8000
Mailing address
8202 BEAGLE DR, HENRICO, VA 23228-3036
(423) 718-2990
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202008528
VA
Other
Enumeration date
06/07/2018
Last updated
05/12/2022
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