Individual
PHILIP MORGAN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
220 DANVILLE CORNER RD, AUBURN, ME 04210-8605
(207) 795-0419
(207) 795-0485
Mailing address
899 RIVERSIDE ST, PORTLAND, ME 04103-1070
(207) 871-1200
(207) 871-1232
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LM11566
ME
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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