Individual
MS. SAMYIAH DESTINY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
46 ALBION ST, BRIDGEPORT, CT 06605-2602
(203) 332-4645
(203) 382-1436
Mailing address
485 ANSON ST, BRIDGEPORT, CT 06606-4704
(203) 923-6789
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/13/2026
Last updated
05/13/2026
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