Organization
MARILYN SLEDGE JACKSON/SAFE HARBOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARILYN SLEDGE JACKSON LCSW/PIP (THERAPIST)
(334) 235-8158
Entity
Organization
Contact information
Practice address
1040 LONGFIELD CT, MONTGOMERY, AL 36117-8055
(334) 288-9009
(334) 288-9497
Mailing address
2325 BRIAR GATE DR, MONTGOMERY, AL 36116-2154
(334) 235-8158
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0942-2160C
AL
1041C0700X
Clinical Social Worker
Primary
2160C
AL
Other
Enumeration date
06/12/2013
Last updated
06/12/2013
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