Individual
AMY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
329 HARDY ST, HATTIESBURG, MS 39401-3824
(000) 000-0000
Mailing address
220 S 40TH AVE, HATTIESBURG, MS 39402-1603
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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