RICHARD ALLEN JACKSON

BRAINERD, MN
NPI1629520770
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: MN  23282)
Enumeration Date2016-10-25
Last Update Date2018-04-12
Business Address
Mr. RICHARD ALLEN JACKSON LICSW
201 W LAUREL ST
BRAINERD, MN 56401-3902
Phone number: 218-454-3844
Mailing Address
Mr. RICHARD ALLEN JACKSON LICSW
823 MAPLE ST
BRAINERD, MN 56401-3770
Phone number: