Stephanie Denise Jackson

NPI #1003459934 in Buckeye, Arizona

Provider Information

NPI Number: 1003459934
Entity Type: Individual
Name: Stephanie Denise Jackson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Foster Care Agency
Enumeration Date: Oct 23, 2019
Last Updated: Mar 10, 2020

Practice Location

Address: 22321 W MORNING GLORY ST
City: Buckeye
State: Arizona
ZIP Code: 85326-7181
Phone: (503) 209-7572

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Foster Care Agency	253J00000X	Primary
Respite Care - Respite Care, Mental Illness, Child — Respite Care, Mental Illness, Child	385HR2055X

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