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1669096244
ELIJAH JAGGER JACKSON
PHILADELPHIA, PA
NPI
1669096244
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: PA CW023481)
Additional Taxonomies
104100000X Social Worker
Enumeration Date
2020-05-30
Last Update Date
2023-05-29
Business Address
ELIJAH JAGGER JACKSON LCSW
201 S 13TH ST APT 1011
PHILADELPHIA, PA 19107-5404
Phone number: 631-346-8485
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Mailing Address
ELIJAH JAGGER JACKSON LCSW
201 S 13TH ST APT 1011
PHILADELPHIA, PA 19107-5404
Phone number: 631-346-8485
Copy
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