IRENE DORMENIE JACKSON

DURHAM, NC
NPI1053927723
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NC  LCAS-26084)
Enumeration Date2020-09-18
Last Update Date2020-09-18
Business Address
IRENE DORMENIE JACKSON LCAS-A
904 WOODGREEN DR
DURHAM, NC 27704-6034
Phone number: 919-641-8358
Mailing Address
IRENE DORMENIE JACKSON LCAS-A
904 WOODGREEN DR
DURHAM, NC 27704-6034
Phone number: 919-641-8358
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