| NPI | 1205233863 |
|---|---|
| Other Name | DARLA NICOLE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60476841) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2023-07-23 |