Jackson, Stephanie Denise

Jackson, Stephanie Denise is an sole proprietor health care provider with primary practice located at 22321 W Morning Glory St , Buckeye AZ 85326-7181. She recently has 2 registered licenses in different health care specialties including Agencies / Foster Care Agency, Respite Care Facility / Respite Care, Mental Illness, Child. Agencies / Foster Care Agency is her primary health care specialty. Jackson, Stephanie Denise can be contacted via phone (503) 209-7572.

Contact Information

Primary practice address
22321 W Morning Glory St Buckeye AZ 85326-7181
Phone: (503) 209-7572
Fax: (602) 455-4624
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Foster Care Agency 253J00000X 9911474 Arizona
Respite Care Facility / Respite Care, Mental Illness, Child 385HR2055X 3311474 Arizona

Profile Details

NPI number 1003459934
LBN Legal business name Jackson, Stephanie Denise
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 23rd, 2019
Last updated Mar 10th, 2020 - about 5 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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