Individual
MRS. MARY ELIZABETH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3013 N RANCHO DR, 128, LAS VEGAS, NV 89130-3345
(702) 272-2222
(702) 272-2221
Mailing address
3013 N RANCHO DR, 128, LAS VEGAS, NV 89130-3345
(702) 272-2222
(702) 272-2221
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5450C
NV
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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