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1518274240
KELLY JACKSON
PHILADELPHIA, PA
NPI
1518274240
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2010-09-01
Last Update Date
2010-09-01
Business Address
-- KELLY JACKSON
112 N BROAD ST
PHILADELPHIA, PA 19102-1512
Phone number: 215-568-0860
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Mailing Address
-- KELLY JACKSON
112 N BROAD ST
PHILADELPHIA, PA 19102-1512
Phone number: 215-568-0860
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