NPI | 1578072567 |
---|---|
Former Name | FRANCES KAY JACKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801106633) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NM C-10767) |
1041C0700X Social Worker, Clinical (Licence: NY 095681) | |
Enumeration Date | 2017-09-22 |
Last Update Date | 2024-01-18 |