Individual
MS. SHAETONNA MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW-LSW
Contact information
Practice address
2820 W CHARLESTON BLVD, C23, LAS VEGAS, NV 89102-1942
(702) 437-4673
(702) 438-4673
Mailing address
995 SIERRA VISTA DR, APT. 328, LAS VEGAS, NV 89169-9387
(765) 635-7698
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6011-S
NV
1041C0700X
Clinical Social Worker
Primary
IC-691
NV
Other
Enumeration date
08/01/2011
Last updated
09/08/2011
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