Individual
MR. BARON JACKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
84 W FREDERICK ST APT 3, MILLERSVILLE, PA 17551-1945
(215) 651-9229
Mailing address
84 W FREDERICK ST APT 3, MILLERSVILLE, PA 17551-1945
(215) 651-9229
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
30945066
PA
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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