Individual
DOMINIQUE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, RCSWI
Contact information
Practice address
71 JAMES HINSON DR, MIDWAY, FL 32343-2264
(850) 405-5068
Mailing address
71 JAMES HINSON DR, MIDWAY, FL 32343-2264
(850) 405-5068
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
ISW22976
FL
Other
Enumeration date
03/30/2026
Last updated
03/30/2026
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