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1417037185
GAIL M JACKSON
PHILADELPHIA, PA
NPI
1417037185
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: PA PC001382)
Enumeration Date
2006-10-17
Last Update Date
2007-07-08
Business Address
-- GAIL M JACKSON MA
BELMONT CENTER, 4200 MONUMENT ROAD
PHILADELPHIA, PA 19131
Phone number: 215-581-5479
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Mailing Address
-- GAIL M JACKSON MA
600 PORTLAND DR
DOWNINGTOWN, PA 19335-4816
Phone number: 215-581-5479
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