Individual
ELIZABETH C JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
3620 W WHITE RIVER BLVD, MUNCIE, IN 47304-4286
(765) 288-1928
(765) 741-0335
Mailing address
240 N. TILLOTSON AVENUE, MUNCIE, IN 47304-3988
(765) 288-1928
(765) 741-0335
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/06/2012
Last updated
09/07/2012
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