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1831607001
SALLY A JACKSON
MADISON, WI
NPI
1831607001
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: WI 9167-123)
Enumeration Date
2018-01-22
Last Update Date
2020-02-07
Business Address
SALLY A JACKSON LCSW
6502 GRAND TETON PLZ
MADISON, WI 53719-1047
Phone number: 608-827-7220
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Mailing Address
SALLY A JACKSON LCSW
6400 INDUSTRIAL LOOP
GREENDALE, WI 53129-2452
Phone number: 414-858-4106
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