| Latoya Jackson, | |
|
3444 Wisconsin Ave, Vicksburg, MS 39180-5331 | |
| (601) 638-0031 | |
| Not Available |
| Full Name | Latoya Jackson |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 3444 Wisconsin Ave, Vicksburg, Mississippi |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063658565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Latoya Jackson, 3444 Wisconsin Ave, Vicksburg, MS 39180-5331 Ph: () - | Latoya Jackson, 3444 Wisconsin Ave, Vicksburg, MS 39180-5331 Ph: (601) 638-0031 |
Kaila Virgil, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3334 Wisconsin Ave., Vicksburg, MS 39180 Phone: 601-638-0031 | |
Tiffany Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950 | |
Felicia Wilson, PCMHT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950 | |
Heather Potts, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 | |
Rosalyn Glascoe, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 | |
Ann Nelson, LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950 | |
Mr. Walter Lee Frazier, MCP, LPC, NCC Counselor Medicare: Medicare Enrolled Practice Location: 1414 Cherry St, Vicksburg, MS 39180 Phone: 601-636-5703 Fax: 601-636-5739 |