STACIE JACKSON

COVINA, CA
NPI1073292306
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy106S00000X Behavior Technician
Additional Taxonomies101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1494190123)
Enumeration Date2023-07-13
Last Update Date2026-10-01
Business Address
STACIE JACKSON
1274 CENTER COURT DR STE 211
COVINA, CA 91724-3668
Phone number: 626-339-4999
Mailing Address
STACIE JACKSON
831 E ARROW HWY
POMONA, CA 91767-2535
Phone number: 909-398-4383