JOSEPH RAY JACKSON

BELLEVILLE, IL
NPI1689011983
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2013-05-28
Last Update Date2013-05-28
Business Address
Mr. JOSEPH RAY JACKSON M.A.
12 N 64TH ST
BELLEVILLE, IL 62223-3809
Phone number: 618-397-0900
Mailing Address
Mr. JOSEPH RAY JACKSON M.A.
12 N 64TH ST
BELLEVILLE, IL 62223-3809
Phone number: 618-397-0900