MRS. Lisa Jackson, LSW

NPI #1265603500 in Coal Grove, Ohio

Provider Information

NPI Number: 1265603500
Entity Type: Individual
Name: MRS. Lisa Jackson, LSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Credential: LSW
Enumeration Date: Mar 14, 2008
Last Updated: Mar 14, 2008

Practice Location

Address: 715 LANE ST
City: Coal Grove
State: Ohio
ZIP Code: 45638-3161
Phone: (740) 355-8606

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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