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1265216097
LACENA T JACKSON
OAKLAND, CA
NPI
1265216097
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-08-22
Last Update Date
2023-08-22
Business Address
Ms. LACENA T JACKSON
2820 35TH AVE APT 9
OAKLAND, CA 94619-1100
Phone number: 510-706-7007
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Mailing Address
Ms. LACENA T JACKSON
2820 35TH AVE APT 9
OAKLAND, CA 94619-1100
Phone number: 510-706-7007
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