Individual
MISS JESSICA IRENE STOCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7075 GOLDEN OAKS LOOP W, STE. 3, SOUTHAVEN, MS 38671-9010
(662) 349-3980
Mailing address
7685 VERANDA BLVD, #2, SOUTHAVEN, MS 38671-3964
(801) 473-1051
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1185
MS
Other
Enumeration date
09/28/2006
Last updated
01/27/2010
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