Individual
MISS KAMALA EVA-MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
7000 AUSTIN ST, FOREST HILLS, NY 11375-1022
(718) 762-7633
(718) 886-8694
Mailing address
7000 AUSTIN ST, FOREST HILLS, NY 11375-1022
(718) 762-7633
(718) 886-8694
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
106246-1
NY
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
04/12/2019
Last updated
04/12/2019
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