Individual
MS. MARY STARK JACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2340 SENTRY DR APT 805, ANCHORAGE, AK 99507-5344
(907) 344-8869
(907) 868-3562
Mailing address
PO BOX 232245, ANCHORAGE, AK 99523-2245
(907) 868-3562
(907) 868-3562
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
902213
AK
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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