Individual
JULIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6915 E MAIN ST, MESA, AZ 85207-8229
(602) 806-2814
(480) 288-1332
Mailing address
202 E. EARLL DR., SUITE 200, PHOENIX, AZ 85012-2647
(602) 808-2800
(602) 808-2716
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
LMSW-14007
AZ
Other
Enumeration date
04/02/2015
Last updated
04/02/2015
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