Individual
MRS. FLORENCE W JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4505 S WASATCH BLVD STE 330B, SALT LAKE CITY, UT 84124-4794
(801) 455-7985
Mailing address
4505 S WASATCH BLVD STE 330B, SALT LAKE CITY, UT 84124-4794
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6224346-3501
UT
Other
Enumeration date
08/24/2010
Last updated
05/25/2021
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