Individual
THERESA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
415 N PERRY ST, DAVENPORT, IA 52801-1617
(563) 209-0313
Mailing address
415 N PERRY ST, DAVENPORT, IA 52801-1617
(563) 328-5821
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.116818
IL
Other
Enumeration date
11/26/2025
Last updated
01/20/2026
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