SHAWN A JACKSON

MEQUON, WI
NPI1487922837
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  16299-130)
Enumeration Date2011-12-13
Last Update Date2013-01-11
Business Address
Mr. SHAWN A JACKSON SAC-IT
10532 N. PORT WASHINGTON RD.
MEQUON, WI 53092
Phone number: 262-242-3810
Mailing Address
Mr. SHAWN A JACKSON SAC-IT
10532 N PORT WASHINGTON RD
MEQUON, WI 53092-5563
Phone number: 262-242-3810
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