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Individual
MARQUAN JACKSON
Active
Individual
MARQUAN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLMSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6801094159
MI
1041C0700X
Clinical Social Worker
Primary
0906016293
VA
Other
Enumeration date
07/15/2014
Last updated
04/13/2025
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