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1891085783
KENNETH ALAN JACKSON
MINNEAPOLIS, MN
NPI
1891085783
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 302997)
Enumeration Date
2011-04-12
Last Update Date
2011-04-12
Business Address
Mr. KENNETH ALAN JACKSON BS, LADC
3329 UNIVERSITY AVE SE
MINNEAPOLIS, MN 55414-3325
Phone number: 612-454-2285
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Mailing Address
Mr. KENNETH ALAN JACKSON BS, LADC
3329 UNIVERSITY AVE SE
MINNEAPOLIS, MN 55414-3325
Phone number: 612-454-2285
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