Individual
MR. ALFRED D. JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
6200 ROCKSIDE WOODS BLVD N STE 305, INDEPENDENCE, OH 44131-2343
(216) 778-9390
Mailing address
18313 HILLER AVE, CLEVELAND, OH 44119-1707
(216) 778-9390
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.0022623
OH
Other
Enumeration date
10/28/2016
Last updated
09/17/2019
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