Individual
BRIANNE AR JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1880 N STATE ROUTE 50 # C, BOURBONNAIS, IL 60914-4432
(815) 641-9630
Mailing address
114 MEADOWS CT, BOURBONNAIS, IL 60914-1120
(815) 641-9630
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.019017
IL
Other
Enumeration date
01/22/2015
Last updated
01/01/2025
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