Individual
BRIANNA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 E CHAMBERS DR, BOONEVILLE, MS 38829-8938
(662) 728-3174
Mailing address
2644 HIGHWAY 371 N, MANTACHIE, MS 38855-7134
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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