Individual
CHANDRA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
367 PINE ST, SPRINGFIELD, MA 01105-1930
(413) 372-9904
Mailing address
14 JAMES ST, SPRINGFIELD, MA 01105-1416
(413) 420-3667
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/24/2019
Last updated
12/24/2019
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