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1366188591
JACKSON L HUECKEL
STATEN ISLAND, NY
NPI
1366188591
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2022-05-10
Last Update Date
2022-05-10
Business Address
JACKSON L HUECKEL CRPA-P
285 VANDERBILT AVE
STATEN ISLAND, NY 10304-2525
Phone number: 718-981-4382
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Mailing Address
JACKSON L HUECKEL CRPA-P
20 STRATFORD AVE APT A
STATEN ISLAND, NY 10301-3831
Phone number: 718-354-0923
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