CALVIN JACKSON

ELIZABETHTOWN, KY
NPI1649226549
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: KY  0274)
Enumeration Date2006-05-25
Last Update Date2008-03-29
Business Address
-- CALVIN JACKSON LPA
1311 N DIXIE HWY
ELIZABETHTOWN, KY 42701-2621
Phone number: 270-769-1304
Mailing Address
-- CALVIN JACKSON LPA
107 CRANES ROOST CT
ELIZABETHTOWN, KY 42701-3650
Phone number: 270-765-2605
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