Individual
JESSICA ASHLEY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
310 W MCKINLEY AVE, MISHAWAKA, IN 46545-5600
(269) 262-1815
(269) 397-2093
Mailing address
25381 STATE ROAD 23, SOUTH BEND, IN 46614-9501
(574) 292-1573
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
99099773A
IN
Other
Enumeration date
10/28/2020
Last updated
02/06/2023
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