NPI 1003756354

Dominique Jackson, MSWRCSWI

Practitioner Marriage & Family Therapist Midway, FL

Practice location

Address: 71 James Hinson Dr, Midway, FL 32343-2264
Phone: (850) 405-5068

Registered specialties

Marriage & Family Therapist Primary

Behavioral Health & Social Service Providers Taxonomy 106H00000X Licence ISW22976 (FL)

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Registry record

NPI: 1003756354
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Mar 2026
Record last updated: 30 Mar 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.