| NPI | 1184275166 |
|---|---|
| Professional Name | KIM ELAINE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW61326871) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC50082406) |
| Enumeration Date | 2019-09-22 |
| Last Update Date | 2024-04-03 |