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1740478155
MICHAEL L JACKSON
PASADENA, CA
NPI
1740478155
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA MFC 16923)
Enumeration Date
2007-10-10
Last Update Date
2007-10-10
Business Address
-- MICHAEL L JACKSON MFT
448 S MARENGO AVE
PASADENA, CA 91101-3113
Phone number: 626-585-9146
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Mailing Address
-- MICHAEL L JACKSON MFT
448 S MARENGO AVE
PASADENA, CA 91101-3113
Phone number: 626-585-9146
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