MARK A JACKSON

VENICE, FL
NPI1972990844
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: FL  SW11508)
Enumeration Date2015-04-18
Last Update Date2015-04-18
Business Address
MARK A JACKSON LCSW
513 MENENDEZ ST
VENICE, FL 34285-2233
Phone number: 917-319-1210
Mailing Address
MARK A JACKSON LCSW
5528 CARTAGENA DR
SARASOTA, FL 34233-3504
Phone number: 917-319-1210
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