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Search › Arizona › 101Y00000X

Sam Jackson, LAC

NPI 1851750061 · on the registry since 2016

Practice

Address
4250 E Florian Ave
Building #1
Mesa, AZ 85206
Phone
(480) 844-1653
Organisation at this address
Marc Community Resources, Inc
Marc Community Resources, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
25

Registry record

Primary taxonomy
101Y00000X
101Y00000X
Licence states on file
AZ
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2016-02-16

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona