MICHAEL JACKSON

SAN FRANCISCO, CA
NPI1760850192
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  154980I)
Enumeration Date2015-09-02
Last Update Date2015-09-02
Business Address
-- MICHAEL JACKSON
815 BUENA VISTA AVE W
SAN FRANCISCO, CA 94117-4108
Phone number: 415-554-1450
Mailing Address
-- MICHAEL JACKSON
815 BUENA VISTA AVE W
SAN FRANCISCO, CA 94117-4108
Phone number: 415-554-1450
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