KENNETH D JACKSON

SHELBY, OH
NPI1457857690
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH  166031)
Enumeration Date2018-04-05
Last Update Date2018-04-05
Business Address
KENNETH D JACKSON CDCA
2775 STATE ROUTE 39
SHELBY, OH 44875-9466
Phone number: 419-747-3322
Mailing Address
KENNETH D JACKSON CDCA
2775 STATE ROUTE 39
SHELBY, OH 44875-9466
Phone number: 419-747-3322
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