Individual
COURTNEY DANIELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
28 BYRD ST, HEMPSTEAD, NY 11550-1943
(516) 304-0522
Mailing address
28 BYRD ST, HEMPSTEAD, NY 11550-1943
(516) 304-0522
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
094810
—
Other
Enumeration date
01/14/2021
Last updated
04/15/2021
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