CODY G JACKSON

BOULDER, CO
NPI1801484423
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: CO  LPC.0016734)
Enumeration Date2021-01-08
Last Update Date2022-09-16
Business Address
CODY G JACKSON MA, LPC
825 S BROADWAY ST STE 35
BOULDER, CO 80305-5932
Phone number: 970-823-2782
Mailing Address
CODY G JACKSON MA, LPC
2020 W 10TH AVE APT 305
BROOMFIELD, CO 80020-6701
Phone number: 970-823-2782
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