Holli Vern Jackson, MSW
Social Worker, Clinical in Bethel, AK. Individual provider (NPI-1).
NPI number1699100511
StatusActive
Last updated in NPPESNov 20, 2019
Details
- NPI
- 1699100511
- Entity type
- Individual (NPI-1)
- Name
- Mr. Holli Vern Jackson
- Credential
- MSW
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 10, 2013
- Last updated
- Nov 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
| 1041C0700X | Social Worker, Clinical | 27403 | CA |
Practice location
829 Chief Eddie Hoffman HwyBethel, AK 99559
Phone 907-543-6100 · Fax 907-543-6159
Mailing address
Po Box 528Bethel, AK 99559-0528
Phone 907-546-6100 · Fax 907-543-6159
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All 22 Clinical Social Worker providers in Bethel · All 1,456 providers in Bethel
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