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1659682037
IDA B JACKSON
CHICAGO, IL
NPI
1659682037
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IL 180-000225)
Enumeration Date
2010-06-30
Last Update Date
2010-06-30
Business Address
Ms. IDA B JACKSON LCPC,
4314 S COTTAGE GROVE AVE SUITE 208
CHICAGO, IL 60653-3514
Phone number: 312-747-0036
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Mailing Address
Ms. IDA B JACKSON LCPC,
4314 S COTTAGE GROVE AVE SUITE 208
CHICAGO, IL 60653-3514
Phone number: 312-747-0036
Copy
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