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1104907187
LAURIE ANN JACKSON
REGO PARK, NY
NPI
1104907187
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY R056949-1)
Enumeration Date
2006-10-18
Last Update Date
2007-07-09
Business Address
Ms. LAURIE ANN JACKSON LCSW R
9745 QUEENS BLVD PH FLOOR
REGO PARK, NY 11374-2101
Phone number: 718-896-9090
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Mailing Address
Ms. LAURIE ANN JACKSON LCSW R
16832 127TH AVE APT 6
JAMAICA, NY 11434-3156
Phone number: 718-525-4864
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