SELENA JACKSON

LAKEPORT, CA
NPI1386810208
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  RI-J0803091809)
Additional Taxonomies101Y00000X Counselor
171M00000X Case Manager/Care Coordinator
Enumeration Date2008-04-30
Last Update Date2017-05-02
Business Address
Miss SELENA JACKSON Breininginstitute
390 N FORBES ST
LAKEPORT, CA 95453-4724
Phone number: 707-994-5486
Mailing Address
Miss SELENA JACKSON Breininginstitute
PO BOX 2077
UKIAH, CA 95482-2077
Phone number: 707-467-2010