Individual
PERONICA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRC, LPCA
Contact information
Practice address
1232 N MAIN ST, HIGH POINT, NC 27262-3118
(336) 884-1475
Mailing address
421 GUILFORD COLLEGE RD, APT T, GREENSBORO, NC 27409-2055
(618) 203-0448
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A10097
NC
Other
Enumeration date
04/01/2013
Last updated
04/01/2013
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