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Individual

ERICA MACK-JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4954 E 56TH ST, INDIANAPOLIS, IN 46220-5773
(317) 500-4266
Mailing address
9110 ELECTRIC CT, INDIANAPOLIS, IN 46260-6104
(317) 960-2770

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
IN
106H00000X
Marriage & Family Therapist
Primary
99091162A
IN

Other

Enumeration date
03/06/2019
Last updated
11/25/2024
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