Individual
ELISHA F JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1824 MURDOCH AVE BLDG C, PARKERSBURG, WV 26101-3230
(304) 916-1881
Mailing address
2306 MOUNT VERNON AVE, POINT PLEASANT, WV 25550-1534
(304) 674-9542
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
S.1701334
OH
104100000X
Social Worker
Primary
AP00944201
WV
Other
Enumeration date
02/14/2018
Last updated
01/10/2019
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