Individual
AYANNA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LMSW
Contact information
Practice address
10190 BANNOCK ST STE 120, NORTHGLENN, CO 80260-6052
(719) 482-0418
Mailing address
711 MCILVAIN ST, CHESTER, PA 19013-6234
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0009925327
CO
Other
Enumeration date
01/13/2025
Last updated
01/13/2025
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