Individual
MS. KATHLEEN PATTERSON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
627 W 4TH ST, LEXINGTON, KY 40508-1207
(859) 246-7483
Mailing address
708 CENTRAL AVE, LEXINGTON, KY 40502-1710
(859) 983-1125
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3044
KY
Other
Enumeration date
06/17/2008
Last updated
06/17/2008
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