NPI | 1649058561 |
---|---|
Professional Name | NATHAN IREX JACKSON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 101YA0400X) |
Enumeration Date | 2023-09-20 |
Last Update Date | 2023-09-20 |