Individual
JUSTICE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
250 W MAIN ST STE 301, BRANFORD, CT 06405-4032
(860) 877-8690
Mailing address
228 JOY LN APT 2, NEW BRITAIN, CT 06053-1709
(860) 877-8690
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7820
CT
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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