Individual
MRS. AMY MICHELLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, ACSW
Contact information
Practice address
225 W HAYDEN ST, SUITE 210, MARCELINE, MO 64658-1049
(660) 376-3200
(660) 376-3204
Mailing address
710 WEST BROADWAY, BRUNSWICK, MO 65236
(660) 634-2380
(660) 376-3204
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2003024017
MO
Other
Enumeration date
12/04/2006
Last updated
07/09/2007
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