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Individual
MS. LESLIE J JACKSON
Active
Individual
MS. LESLIE J JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
084870
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05160852
—
NY
Enumeration date
05/26/2017
Last updated
07/21/2022
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