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1700558871
DERICKA JACKSON
TAMPA, FL
NPI
1700558871
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
104100000X Social Worker
(Licence: FL 15603)
Enumeration Date
2021-09-28
Last Update Date
2021-09-28
Business Address
DERICKA JACKSON
4440 BASS ST
TAMPA, FL 33617-8202
Phone number: 813-384-1568
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Mailing Address
DERICKA JACKSON
4440 BASS ST
TAMPA, FL 33617-8202
Phone number: 813-384-1568
Copy
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