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1427417906
KEENAN JACKSON
PHOENIX, AZ
NPI
1427417906
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
(Licence: AZ 6889840)
Enumeration Date
2016-02-12
Last Update Date
2016-02-12
Business Address
-- KEENAN JACKSON
4449 N 12TH ST
PHOENIX, AZ 85014-4520
Phone number: 602-279-1427
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Mailing Address
-- KEENAN JACKSON
PO BOX 16906
PHOENIX, AZ 85011-6906
Phone number: 602-279-1427
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