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1881930006
BETHENA M JACKSON
DURHAM, NC
NPI
1881930006
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NC 2421)
Enumeration Date
2012-12-15
Last Update Date
2012-12-15
Business Address
Ms. BETHENA M JACKSON CSAC, LCAS-A
2604 CARVER ST SUITE C
DURHAM, NC 27705-2796
Phone number: 919-682-4771
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Mailing Address
Ms. BETHENA M JACKSON CSAC, LCAS-A
2109 PEAR TREE LN
DURHAM, NC 27703-6280
Phone number: 919-633-8360
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