Antoinette Jackson's National Provider Identifier (NPI) Details
Antoinette Jackson, LPC
NPI: 1700439171
Enumeration Date: 2019-07-24
Last updated: 2019-07-24
Sole Proprietor: YES
Status: active
Postal Address: 6014 CATHARINE ST # B, PHILADELPHIA, PA
Phone: 215-432-8608
Primary Practice Address: 6122 RIDGE AVE, PHILADELPHIA, PA
Practice's phone: 215-487-1330