Individual
MS. GRETCHEN D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
2 TERMINAL DR, SUITE 8, EAST ALTON, IL 62024-2201
(618) 258-0485
(618) 258-4815
Mailing address
2 TERMINAL DR, SUITE 8, EAST ALTON, IL 62024-2201
(618) 258-0485
(618) 258-4815
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
018-006325
IL
Other
Enumeration date
01/29/2009
Last updated
01/29/2009
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