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1033462932
GARY D JACKSON
EL MONTE, CA
NPI
1033462932
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Other Name
GARY D JACKSON
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 3055-R)
Enumeration Date
2012-10-17
Last Update Date
2012-10-17
Business Address
-- GARY D JACKSON
4610 SANTA ANITA BLVD, SUITE D
EL MONTE, CA 91731
Phone number: 626-453-3432
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Mailing Address
-- GARY D JACKSON
1800 WEST BADILLO #919
WEST COVINA, CA 91790
Phone number: 626-960-3258
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