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1073292306
STACIE JACKSON
POMONA, CA
NPI
1073292306
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1494190123)
Enumeration Date
2023-07-13
Last Update Date
2024-04-18
Business Address
STACIE JACKSON
831 E ARROW HWY
POMONA, CA 91767-2535
Phone number: 909-398-4383
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Mailing Address
STACIE JACKSON
831 E ARROW HWY
POMONA, CA 91767-2535
Phone number: 909-398-4383
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