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1821249541
LEON JACKSON PERNELL
HENDERSON, NC
NPI
1821249541
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NC 56)
Enumeration Date
2008-10-01
Last Update Date
2008-10-01
Business Address
Mr. LEON JACKSON PERNELL LCAS
804 S GARNETT ST
HENDERSON, NC 27536-4571
Phone number: 252-430-8774
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Mailing Address
Mr. LEON JACKSON PERNELL LCAS
804 S GARNETT ST
HENDERSON, NC 27536-4571
Phone number: 252-430-8774
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