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1205400561
DOMINIQUE JACKSON
PHOENIX, AZ
NPI
1205400561
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
Enumeration Date
2021-05-19
Last Update Date
2021-05-19
Business Address
DOMINIQUE JACKSON
1705 E CARSON RD
PHOENIX, AZ 85042-5748
Phone number: 480-226-5734
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Mailing Address
DOMINIQUE JACKSON
PO BOX 16906
PHOENIX, AZ 85011-6906
Phone number:
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