Chandra Jackson
Social Worker, Clinical in Springfield, MA. Individual provider (NPI-1).
NPI number1982243853
StatusActive
Last updated in NPPESDec 24, 2019
Details
- NPI
- 1982243853
- Entity type
- Individual (NPI-1)
- Name
- Chandra Jackson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 24, 2019
- Certification date
- Dec 24, 2019
- Last updated
- Dec 24, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Practice location
367 Pine StSpringfield, MA 01105-1930
Phone 413-372-9904
Mailing address
14 James StSpringfield, MA 01105-1416
Phone 413-420-3667
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