Jackson, Marian A

Jackson, Marian A is an individual health care provider with primary practice located at 125 N Ruby Ln , Fairview Heights IL 62208-1926. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jackson, Marian A can be contacted via phone (618) 398-4226.

Contact Information

Primary practice address
125 N Ruby Ln Fairview Heights IL 62208-1926
Phone: (618) 398-4226
Fax: (618) 398-1759
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149.015627 Illinois

Profile Details

NPI number 1427394485
LBN Legal business name Jackson, Marian A
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2012
Last updated Dec 19th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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