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1376622217
ALICIA CAROL JACKSON
BROOKLYN, NY
NPI
1376622217
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY 069227-1)
Enumeration Date
2006-11-02
Last Update Date
2007-07-08
Business Address
-- ALICIA CAROL JACKSON 01/31/05
2094 PITKIN AVE
BROOKLYN, NY 11207-3509
Phone number: 718-240-0602
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Mailing Address
-- ALICIA CAROL JACKSON 01/31/05
3520 24TH ST APT. 6F
LONG ISLAND CITY, NY 11106-4470
Phone number: 718-706-8097
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