Individual
AMBREA DIONNE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
302 DANS XING, MADISON, AL 35757-5905
(580) 917-3332
Mailing address
302 DANS XING, MADISON, AL 35757-5905
(580) 917-3332
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW009856
GA
Other
Enumeration date
11/05/2025
Last updated
11/05/2025
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