TONY A JACKSON

SHELBY, OH
NPI1568968626
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH  CDCA165157)
Enumeration Date2018-04-05
Last Update Date2018-04-05
Business Address
TONY A JACKSON CDCA
2775 STATE ROUTE 39
SHELBY, OH 44875-9466
Phone number: 419-747-3322
Mailing Address
TONY A JACKSON CDCA
2775 STATE ROUTE 39
SHELBY, OH 44875-9466
Phone number: 419-747-3322
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