ELLIS JACKSON

TUPELO, MS
NPI1225798143
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2021-12-20
Last Update Date2021-12-20
Business Address
ELLIS JACKSON
2434 S EASON BLVD
TUPELO, MS 38804-6942
Phone number: 662-640-6416
Mailing Address
ELLIS JACKSON
2434 S EASON BLVD
TUPELO, MS 38804-6942
Phone number: 662-640-6416
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