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1659730414
SHAWANA JACKSON
HAWTHORNE, CA
NPI
1659730414
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA CAADE 5365-R)
Enumeration Date
2016-02-22
Last Update Date
2016-02-22
Business Address
-- SHAWANA JACKSON
13715 CORDARY AVE APT 246
HAWTHORNE, CA 90250-7419
Phone number: 310-661-0441
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Mailing Address
-- SHAWANA JACKSON
13715 CORDARY AVE APT 246
HAWTHORNE, CA 90250-7419
Phone number: 310-661-0441
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