Most Relevant Information
Provider Data
| NPI Number: | 1003645052 |
| Provider Name: | ALICIA JACKSON LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 095025 |
Most Important Dates
| Enumeration Date: | 07/29/2024 |
| Last Updated: | 07/29/2024 |
Provider Practice Location
61 MALTA ST APT 4A
BROOKLYN
NY
112076766
Practice Location Phone/Fax
| Phone: | 9177535895 |
| Fax: |
Provider Mailing Location
61 MALTA ST APT 4A
BROOKLYN
NY
112076766
Provider Mailing Phone/Fax
| Phone: | 9177535895 |
| Fax: |