SANDRA J JACKSON

SOUTH BEND, IN
NPI1124449053
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IN  88000353A)
Enumeration Date2013-12-19
Last Update Date2013-12-19
Business Address
Ms. SANDRA J JACKSON LCAC CADAC IV NADAC
4218 WESTERN AVE.
SOUTH BEND, IN 46619
Phone number: 574-233-1524
Mailing Address
Ms. SANDRA J JACKSON LCAC CADAC IV NADAC
4218 WESTERN AVE.
SOUTH BEND, IN 46619
Phone number: 574-274-1524
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