Individual
ALEXIS JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
211 S LOWELL AVE # 2, SYRACUSE, NY 13204-2632
(315) 507-1885
Mailing address
211 S LOWELL AVE # 2, SYRACUSE, NY 13204-2632
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
122308
NY
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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