Individual
MRS. HOLLY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
511 W 86TH TER, KANSAS CITY, MO 64114-2822
(816) 377-6872
Mailing address
511 W 86TH TER, KANSAS CITY, MO 64114-2822
(816) 377-6872
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7967
KS
Other
Enumeration date
01/11/2011
Last updated
01/11/2011
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