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1720225113
ALONZO JACKSON
AUSTIN, TX
NPI
1720225113
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: TX 9841)
Enumeration Date
2009-01-07
Last Update Date
2009-01-07
Business Address
MR. ALONZO JACKSON LCDC
1643 E 2ND ST
AUSTIN, TX 78702-4411
Phone number: 512-472-4357
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Mailing Address
MR. ALONZO JACKSON LCDC
1430 COLLIER ST
AUSTIN, TX 78704-2911
Phone number: 512-445-7787
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