Individual
MICHAEL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., N.C.C,
Contact information
Practice address
128 MUTE SWAN PLACE, NEWARK, DE 19711
(786) 333-8982
Mailing address
2415 E ERIC DR, WILMINGTON, DE 19808-4206
(786) 333-8982
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
AC-0000107
DE
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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