SHAWANA JACKSON

HAWTHORNE, CA
NPI1659730414
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  CAADE 5365-R)
Enumeration Date2016-02-22
Last Update Date2016-02-22
Business Address
-- SHAWANA JACKSON
13715 CORDARY AVE APT 246
HAWTHORNE, CA 90250-7419
Phone number: 310-661-0441
Mailing Address
-- SHAWANA JACKSON
13715 CORDARY AVE APT 246
HAWTHORNE, CA 90250-7419
Phone number: 310-661-0441