Individual
MARCIA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT, OTR/L
Contact information
Practice address
3521 W BROWARD BLVD FL 3, FORT LAUDERDALE, FL 33312-1048
(954) 587-1008
(954) 587-0080
Mailing address
3521 W BROWARD BLVD FL 3, FT LAUDERDALE, FL 33312-1048
(954) 587-1008
(954) 587-0080
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000
FL
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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