GARY D JACKSON

EL MONTE, CA
NPI1033462932
Other NameGARY D JACKSON
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  3055-R)
Enumeration Date2012-10-17
Last Update Date2012-10-17
Business Address
-- GARY D JACKSON
4610 SANTA ANITA BLVD, SUITE D
EL MONTE, CA 91731
Phone number: 626-453-3432
Mailing Address
-- GARY D JACKSON
1800 WEST BADILLO #919
WEST COVINA, CA 91790
Phone number: 626-960-3258
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