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1013245828
WAYNE HARRISON JACKSON
CAMARILLO, CA
NPI
1013245828
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2009-12-07
Last Update Date
2009-12-07
Business Address
Mr. WAYNE HARRISON JACKSON
1722 S LEWIS RD
CAMARILLO, CA 93012-8520
Phone number: 805-928-8622
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Mailing Address
Mr. WAYNE HARRISON JACKSON
124 CARMEN LN STE J-L
SANTA MARIA, CA 93458-7768
Phone number: 805-928-8622
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