Individual
TERRA HAROLD JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3890 DUNN AVE, SUITE 1104, JACKSONVILLE, FL 32218-6428
(904) 723-6049
(904) 723-5049
Mailing address
3890 DUNN AVE, SUITE 1104, JACKSONVILLE, FL 32218-6428
(904) 723-6049
(904) 723-5049
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/30/2016
Last updated
06/30/2016
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