Individual
MS. LUCILLE G COCKERHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1500 E WOODROW WILSON, JACKSON, MS 39216-5199
(601) 362-4471
(601) 368-4409
Mailing address
454 FOREST AVE, JACKSON, MS 39206
(601) 362-4471
(601) 368-4409
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C1188
MS
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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