| NPI | 1821277328 |
|---|---|
| Other Name | LISA K JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ND 4194) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2022-11-17 |