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Individual

MARCIA ANTIONETTE JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
4530 S DECATUR BLVD, STE 201B, LAS VEGAS, NV 89103
(702) 486-5185
Mailing address
1350 S. JONES BLVD, STE 220, LAS VEGAS, NV 89146
(775) 688-2489

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10461-C
NV
1041C0700X
Clinical Social Worker
149019143
IL

Other

Enumeration date
05/30/2019
Last updated
04/17/2024
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