Individual
LAURIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
107 IMPERIAL BLVD, HENDERSONVILLE, TN 37075-3479
(615) 618-5029
(615) 757-3152
Mailing address
107 IMPERIAL BLVD, HENDERSONVILLE, TN 37075-3479
(156) 185-0296
(615) 757-3152
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9553
TN
Other
Enumeration date
12/27/2012
Last updated
08/12/2019
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