Individual
MRS. CAREY LUCILE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
290 N 10TH ST STE 102, COLTON, CA 92324-3052
(909) 825-6188
(909) 872-0652
Mailing address
290 N 10TH ST STE 102, COLTON, CA 92324-3052
(909) 825-6188
(909) 872-0652
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/14/2007
Last updated
07/08/2007
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