Melodie Isma Jackson
Counselor in Philadelphia, PA. Individual provider (NPI-1).
NPI number1295028645
StatusActive
Last updated in NPPESMay 18, 2011
Details
- NPI
- 1295028645
- Entity type
- Individual (NPI-1)
- Name
- Melodie Isma Jackson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 18, 2011
- Last updated
- May 18, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
1401 S 4th StPhiladelphia, PA 19147-5948
Phone 215-339-1070 · Fax 215-339-1080
Mailing address
432 N 6th StPhiladelphia, PA 19123-4004
Phone 215-925-2400 · Fax 215-925-9162
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