TY'SHUNNA JACKSON

VENICE, CA
NPI1154518835
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-09-26
Last Update Date2007-09-26
Business Address
-- TY'SHUNNA JACKSON
717 LINCOLN BLVD
VENICE, CA 90291-2845
Phone number: 310-399-9883
Mailing Address
-- TY'SHUNNA JACKSON
26460 SUMMIT CIR
SANTA CLARITA, CA 91350-2991
Phone number:
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