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1174217996
CHRISTOPHER JACKSON
SOUTHLAKE, TX
NPI
1174217996
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: TX 83240)
Enumeration Date
2023-06-05
Last Update Date
2023-06-05
Business Address
CHRISTOPHER JACKSON
1100 E SOUTHLAKE BLVD STE 200
SOUTHLAKE, TX 76092-6381
Phone number: 817-756-1293
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Mailing Address
CHRISTOPHER JACKSON
14320 PADDEN PARK LN
ROANOKE, TX 76262-2140
Phone number:
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