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1487980652
CAROL DENISE JACKSON
DES MOINES, IA
NPI
1487980652
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IA 92151)
Enumeration Date
2009-10-23
Last Update Date
2009-10-23
Business Address
Mrs. CAROL DENISE JACKSON ACADC
1522 17TH STREET
DES MOINES, IA 50314-0000
Phone number: 515-279-0335
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Mailing Address
Mrs. CAROL DENISE JACKSON ACADC
1522 17TH ST
DES MOINES, IA 50314-1418
Phone number: 515-279-0335
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