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Individual

ASHLEY MARIE JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW, MSW

Contact information

Practice address
841 JIMMY ANN DR, DAYTONA BEACH, FL 32117-4583
(386) 425-3900
(386) 274-4140
Mailing address
841 JIMMY ANN DR, DAYTONA BEACH, FL 32117-4583
(386) 425-3900
(386) 274-4140

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LICSW

Other

Enumeration date
02/22/2013
Last updated
02/22/2013
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