Individual
NATASHA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 LEESTOWN RD, LEXINGTON, KY 40511-1052
(859) 233-4511
Mailing address
1566 GRANT PL, LEXINGTON, KY 40511-1652
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6723
KY
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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