Individual
MRS. AMANDA MICHELLE JACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
121 E 3RD ST, RUSHVILLE, IN 46173-2208
(765) 932-5905
Mailing address
7347 S BASE RD, MILROY, IN 46156-9757
(765) 561-6339
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006036A
IN
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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