Devonte Jackson

NPI #1417461120 in Lake Village, Arkansas

Provider Information

NPI Number: 1417461120
Entity Type: Individual
Name: Devonte Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Nov 17, 2017
Last Updated: Nov 17, 2017

Practice Location

Address: 1652 S HIGHWAY 65 82
City: Lake Village
State: Arkansas
ZIP Code: 71653-1662
Phone: (870) 265-3711

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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