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1871175307
JASON JON BURRIS
KINGMAN, AZ
NPI
1871175307
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ LISAC-6894T)
Enumeration Date
2021-04-23
Last Update Date
2024-07-02
Business Address
JASON JON BURRIS MS, LISAC
3505 WESTERN AVE
KINGMAN, AZ 86409-3071
Phone number: 928-757-8111
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Mailing Address
JASON JON BURRIS MS, LISAC
552 RAMAR RD
BULLHEAD CITY, AZ 86442-6215
Phone number: 928-266-9024
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