DERIC R JACKSON

HASTINGS, MN
NPI1093423337
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: MN  21544)
Enumeration Date2022-11-07
Last Update Date2022-11-28
Business Address
Mr. DERIC R JACKSON LICSW
1320 S FRONTAGE RD STE 200
HASTINGS, MN 55033-2481
Phone number: 651-500-0905
Mailing Address
Mr. DERIC R JACKSON LICSW
1320 S FRONTAGE RD
HASTINGS, MN 55033-2684
Phone number: 651-500-0905
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