Individual
MS. CAROLYN JANE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
200 S HOOVER BLVD, SUITE 170, TAMPA, FL 33609-3540
(727) 692-7096
Mailing address
PO BOX 320331, TAMPA, FL 33679-2331
(727) 692-7096
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW10436
FL
Other
Enumeration date
05/12/2012
Last updated
05/12/2012
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