STACIE JACKSON

POMONA, CA
NPI1073292306
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1494190123)
Enumeration Date2023-07-13
Last Update Date2024-04-18
Business Address
STACIE JACKSON
831 E ARROW HWY
POMONA, CA 91767-2535
Phone number: 909-398-4383
Mailing Address
STACIE JACKSON
831 E ARROW HWY
POMONA, CA 91767-2535
Phone number: 909-398-4383
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