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1639625833
MICHAEL JACKSON
NEWARK, DE
NPI
1639625833
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: DE AC-0000107)
Enumeration Date
2016-08-28
Last Update Date
2016-08-28
Business Address
-- MICHAEL JACKSON M.A., N.C.C,
128 MUTE SWAN PLACE
NEWARK, DE 19711
Phone number: 786-333-8982
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Mailing Address
-- MICHAEL JACKSON M.A., N.C.C,
2415 E ERIC DR
WILMINGTON, DE 19808-4206
Phone number: 786-333-8982
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