IndividualActive
Domenica Jackson
NPI 1922870179 · Social Worker · Russellville, AL
Provider details
- NPI number
- 1922870179
- Entity type
- Individual
- Primary specialty
- Social WorkerBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 6371G (AL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
12260 Highway 43
Russellville, AL 35653-4737
Phone: (256) 710-8558
Approximate (ZIP-level) locationGet directions
Mailing address
238 Lewis St
Muscle Shoals, AL 35661-1630
Registry dates
- Enumerated
- 2023-10-23
- Last updated
- 2024-03-03
- Certified
- 2024-03-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.