MICHAEL JACKSON

CANTON, OH
NPI1730503822
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH  1300648)
Enumeration Date2014-02-10
Last Update Date2014-02-10
Business Address
-- MICHAEL JACKSON CT,CDCA
1341 MARKET AVE N
CANTON, OH 44714-2605
Phone number: 330-453-8252
Mailing Address
-- MICHAEL JACKSON CT,CDCA
1341 MARKET AVE N
CANTON, OH 44714-2605
Phone number: 330-453-8252
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