Individual
LAUREN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4013 BEATLINE RD, LONG BEACH, MS 39560-4135
(228) 200-0720
Mailing address
4013 BEATLINE RD, LONG BEACH, MS 39560-4135
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P-1140
MS
Other
Enumeration date
01/02/2025
Last updated
01/02/2025
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