Individual
ANNIE MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
8549 SOUTHAVEN CIR W, SOUTHAVEN, MS 38671-2919
(662) 721-0814
Mailing address
8549 SOUTHAVEN CIR W, SOUTHAVEN, MS 38671-2919
(662) 721-0814
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
13907
TN
104100000X
Social Worker
Primary
M8955
MS
Other
Enumeration date
02/08/2023
Last updated
02/08/2023
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