Individual
MS. MARIE C JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CSW
Contact information
Practice address
660 S 200 E, STE 308, SALT LAKE CITY, UT 84111-3835
(801) 355-2846
(801) 359-3244
Mailing address
1435 HUDSON AVE, SALT LAKE CITY, UT 84106-3435
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
58314003502
UT
Other
Enumeration date
09/15/2006
Last updated
07/08/2007
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