Individual
KIARA S JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
474R SCHOOL ST, EAST HARTFORD, CT 06108-1149
(860) 730-8811
Mailing address
2 WATERSIDE XING STE 401, WINDSOR, CT 06095-1587
(860) 697-3351
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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