Individual
ASHLEY J JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
30 ELIZABETH ST, DERBY, CT 06418-1869
(203) 954-0543
Mailing address
4 CAPTAINS WATCH, SHELTON, CT 06484-5914
(203) 922-2240
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
008469
CT
Other
Enumeration date
08/30/2010
Last updated
09/09/2021
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