Individual
JOSHUA DEAN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 MAIN PLACE, 500 N MAIN ST STE 156, NEWTON, KS 67114
(316) 202-4414
Mailing address
208 BROOKSIDE DR, NEWTON, KS 67114-4612
(580) 512-0053
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13479
KS
Other
Enumeration date
03/14/2024
Last updated
03/14/2024
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