Kelly Jackson
NPI #1407522428 in Cedar Lake, Indiana
Provider Information
- NPI Number
- 1407522428
- Entity Type
- Individual
- Name
- Kelly Jackson
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Aug 19, 2021
- Last Updated
- Aug 19, 2021
Practice Location
- Address
- 11631 CEDAR ST
- City
- Cedar Lake
- State
- Indiana
- ZIP Code
- 46303-7290
- Phone
- (219) 682-8211
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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