ISAAC L. JACKSON

RAEFORD, NC
NPI1093066037
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NC  2199-A)
Enumeration Date2012-10-01
Last Update Date2012-10-01
Business Address
Mr. ISAAC L. JACKSON LCAS-A
113 W ELWOOD AVE
RAEFORD, NC 28376-2801
Phone number: 910-848-1638
Mailing Address
Mr. ISAAC L. JACKSON LCAS-A
113 W ELWOOD AVE
RAEFORD, NC 28376-2801
Phone number: 910-848-1638
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