Individual
ADRIENNE MICHELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
29 FLINT WAY, BLYTHEWOOD, SC 29016-5827
(803) 920-3946
Mailing address
29 FLINT WAY, BLYTHEWOOD, SC 29016-5827
(803) 920-3946
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
16273
SC
Other
Enumeration date
01/12/2022
Last updated
08/24/2023
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