WILLIE LEE JACKSON

LOS ANGELES, CA
NPI1013143395
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2009-06-01
Last Update Date2009-06-01
Business Address
-- WILLIE LEE JACKSON
157 SANTA BARBARA PLZ
LOS ANGELES, CA 90008-2508
Phone number: 323-293-2717
Mailing Address
-- WILLIE LEE JACKSON
157 SANTA BARBARA PLZ
LOS ANGELES, CA 90008-2508
Phone number: 323-293-2717
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