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1013640036
SHASA JACKSON
AVONDALE, AZ
NPI
1013640036
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: AZ LCSW-20522)
Enumeration Date
2022-07-07
Last Update Date
2022-07-07
Business Address
Dr. SHASA JACKSON LCSW, DBH
950 E VAN BUREN ST
AVONDALE, AZ 85323-1506
Phone number: 623-344-6860
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Mailing Address
Dr. SHASA JACKSON LCSW, DBH
2619 E. ROOSEVELT
PHOENIX, AZ 85008
Phone number:
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