NANNIE JACKSON

PHOENIX, AZ
NPI1467823435
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ  LISAC 11861)
Enumeration Date2015-10-15
Last Update Date2015-10-15
Business Address
-- NANNIE JACKSON
9201 N 5TH ST
PHOENIX, AZ 85020-2532
Phone number: 602-331-5792
Mailing Address
-- NANNIE JACKSON
2500 W UTOPIA RD SUITE 100
PHOENIX, AZ 85027-4171
Phone number: 623-434-6200
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