Search › Mississippi › 101Y00000X
Jaquay Jackson, CMHT
NPI 1396307179 · on the registry since 2019
Practice
- Address
- 119 S 12th Ave
Laurel, MS 39440 - Phone
- (601) 342-8215
- Organisation at this address
- Sergio G Gonzalez Md Pa
Laboratory Corporation Of America HoldingsInferred from a shared address, not stated in the registry. - Clinicians at this address
- 35
Registry record
- Primary taxonomy
- 101Y00000X
101Y00000X
- Also registered as
- 101YM0800X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2019-07-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi