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1225549850
CORYNNE M JACKSON
VANCOUVER, WA
NPI
1225549850
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: WA CG60803098)
Enumeration Date
2017-10-23
Last Update Date
2017-10-23
Business Address
CORYNNE M JACKSON
1014 MAIN ST
VANCOUVER, WA 98660-3151
Phone number: 360-695-1014
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Mailing Address
CORYNNE M JACKSON
1014 MAIN ST
VANCOUVER, WA 98660-3151
Phone number: 360-695-1014
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