Individual
MARGARET JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 MARJORIE LN, MANCHESTER, CT 06042-2079
(860) 698-0294
Mailing address
111 MARJORIE LN, MANCHESTER, CT 06042-2079
(860) 698-0294
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
6968
CT
Other
Enumeration date
02/29/2016
Last updated
01/17/2024
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