TIMOTHY WAYNE JACKSON

FRESNO, CA
NPI1124809363
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  16460)
Enumeration Date2023-10-12
Last Update Date2023-10-12
Business Address
TIMOTHY WAYNE JACKSON
2772 S MARTIN L KING JR BLVD
FRESNO, CA 93706-5345
Phone number: 559-265-4800
Mailing Address
TIMOTHY WAYNE JACKSON
2772 S MARTIN L KING JR BLVD
FRESNO, CA 93706-5345
Phone number: 559-265-4800
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