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Individual
MS. FAIZA OMER JACKSON
Active
Individual
MS. FAIZA OMER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
150.012194
IL
1041C0700X
Clinical Social Worker
Primary
0904010831
VA
1041C0700X
Clinical Social Worker
23189
MD
Other
Enumeration date
06/28/2011
Last updated
04/03/2019
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