Individual
VIANA GARCIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2500 E VAN BUREN ST, PHOENIX, AZ 85008-6037
(602) 220-6022
Mailing address
12371 W JACKSON ST, AVONDALE, AZ 85323-8051
(787) 564-7185
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
13544
AZ
Other
Enumeration date
03/02/2010
Last updated
12/19/2012
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