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Individual

CLIFFORD JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW, LCSW

Contact information

Practice address
1199 ARABIAN DR, ASHEBORO, NC 27205-1802
(336) 626-7901
Mailing address
1199 ARABIAN DR, ASHEBORO, NC 27205-1802
(336) 626-7901

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C007745
NC
106H00000X
Marriage & Family Therapist
C007745
NC

Other

Enumeration date
06/09/2012
Last updated
06/09/2012
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