Individual
MRS. KIMBERLY S JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
841 JIMMY ANN DR, DAYTONA BEACH, FL 32117-4583
(386) 425-3953
(386) 258-4912
Mailing address
841 JIMMY ANN DR, DAYTONA BEACH, FL 32117-4583
(386) 425-3953
(386) 258-4912
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ISW 3000
FL
Other
Enumeration date
12/07/2009
Last updated
03/13/2013
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