Individual
MR. TROY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
2109 CHANCELLOR ST, PHILADELPHIA, PA 19103-4823
(267) 235-8800
Mailing address
2109 CHANCELLOR ST, PHILADELPHIA, PA 19103-4823
(267) 235-8800
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW131379
PA
Other
Enumeration date
08/12/2014
Last updated
08/12/2014
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