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1205249000
DWAINE JACKSON
COMPTON, CA
NPI
1205249000
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2014-06-09
Last Update Date
2014-06-09
Business Address
-- DWAINE JACKSON
1500 E KAY ST
COMPTON, CA 90221-1752
Phone number: 310-898-2450
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Mailing Address
-- DWAINE JACKSON
1500 E KAY ST
COMPTON, CA 90221-1752
Phone number: 310-898-2450
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