Individual provider · Type 1 NPI

Susan Jackson

Professional Counselor · Philadelphia, PA

NPI number 1629402995 Active

Practice location

4510 Frankford Ave, 2nd Floor
Philadelphia, PA 19124-3602

Call (215) 744-1302 Map

Fax (215) 744-2544

Mailing address

432 N 6th St
Philadelphia, PA 19123-4004

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XNone listed

Professional Counselor: Definition to come...

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About NPI 1629402995

Susan Jackson's National Provider Identifier is 1629402995, issued on Aug 22, 2013. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Philadelphia, PA. The record was last updated on Aug 22, 2013.