Individual
LAZERRICK JONMONTA TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
341 EDGEWOOD TERRACE DR, JACKSON, MS 39206-6217
(601) 487-6344
(601) 398-0289
Mailing address
341 EDGEWOOD TERRACE DR, JACKSON, MS 39206-6217
(601) 487-6344
(601) 398-0289
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/17/2023
Last updated
04/14/2025
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