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1205679875
ANISSA JACKSON
DALLAS, TX
NPI
1205679875
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: TX 15987)
Enumeration Date
2024-06-13
Last Update Date
2024-06-13
Business Address
ANISSA JACKSON LCDC
1601 ELM ST STE 4360
DALLAS, TX 75201-4701
Phone number: 562-296-2730
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Mailing Address
ANISSA JACKSON LCDC
1601 ELM ST STE 4360
DALLAS, TX 75201-4701
Phone number: 562-296-2730
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