OCTAVIA MARY JACKSON

BRONX, NY
NPI1588523419
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: NY  015528)
Enumeration Date2026-01-16
Last Update Date2026-01-16
Business Address
OCTAVIA MARY JACKSON
4215 PARK AVE
BRONX, NY 10457-6073
Phone number: 917-870-2097
Mailing Address
OCTAVIA MARY JACKSON
4215 PARK AVE
BRONX, NY 10457-6073
Phone number:
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