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1346799830
THEODORE JACKSON
SYRACUSE, NY
NPI
1346799830
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
104100000X Social Worker
(Licence: NY 098808)
Enumeration Date
2016-09-26
Last Update Date
2016-09-26
Business Address
-- THEODORE JACKSON
1045 JAMES ST
SYRACUSE, NY 13203-2730
Phone number: 315-472-4471
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Mailing Address
-- THEODORE JACKSON
1045 JAMES ST
SYRACUSE, NY 13203-2730
Phone number: 315-472-4471
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