Individual
AMANDA ANN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8207 MAIN ST, WILLIAMSVILLE, NY 14221-6060
(716) 381-0770
Mailing address
6039 EMERSON DR, ORCHARD PARK, NY 14127-2371
(716) 381-0770
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
100487-01
NY
Other
Enumeration date
09/04/2019
Last updated
11/19/2025
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