Individual
CHENITA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCWSA
Contact information
Practice address
300 VEAZEY DR, BUTNER, NC 27509-1668
(919) 764-5446
(919) 764-2181
Mailing address
300 VEAZEY DR, BUTNER, NC 27509-1668
(919) 764-5446
(919) 764-2181
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P013882
NC
Other
Enumeration date
02/17/2020
Last updated
02/17/2020
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