Lataya Jackson

NPI 1710392865 - Counselor - 101Y00000X

NPI Details
NPI 1710392865
Gender Female
Enumeration Date 06/27/2014
Last Updated 06/27/2014
Entity Type Individual
Active Over 2 years ago
Practice Location
602 N WALTON BLVD
BENTONVILLE AR, 72712-4576, US
Phone (479) 464-1060
Fax (479) 271-6307
Business Location
602 N WALTON BLVD
BENTONVILLE AR, 72712-4576, US
Phone (479) 464-1060
Fax (479) 271-6307
Toxanomy
Taxonomy Code 101Y00000X
License State
License Number
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According to our database, Lataya Jackson NPI is 1710392865, taxonomy code is 101Y00000X Lataya Jackson physically located at 602 N Walton Blvd, Bentonville AR, 72712-4576. NPI Number Lataya Jackson has the Individual type.

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1710392865 NPI number is provided on an as is basis without warranty of any kind. 1710392865 is maintained by the National Plan & Provider Enumeration System. The contents of Lataya Jackson are for informational purposes only.