KEVIN JACKSON

SAN BERNARDINO, CA
NPI1164845400
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2014-01-22
Last Update Date2020-01-14
Business Address
KEVIN JACKSON
621 E CARNAGIE DR # 210 SAN BERNARDINO CA 92415
SAN BERNARDINO, CA 92415-3919
Phone number: 909-386-9767
Mailing Address
KEVIN JACKSON
621 E CARNAGIE DR # 210 SAN BERNARDINO CA 92415
SAN BERNARDINO, CA 92415-0530
Phone number: 909-386-9767
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