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1619460698
KEISHA G JACKSON
EVANSVILLE, IN
NPI
1619460698
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IN 99086417A)
Enumeration Date
2018-06-13
Last Update Date
2018-06-13
Business Address
KEISHA G JACKSON LSW
4411 WASHINGTON AVE STE 300
EVANSVILLE, IN 47714-0900
Phone number: 812-479-1916
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Mailing Address
KEISHA G JACKSON LSW
4411 WASHINGTON AVE STE 300
EVANSVILLE, IN 47714-0900
Phone number: 812-479-1916
Copy
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