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1891368668
LEE E JACKSON
DESOTO, TX
NPI
1891368668
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: TX 13217)
Enumeration Date
2021-07-20
Last Update Date
2021-07-20
Business Address
LEE E JACKSON
1229 E PLEASANT RUN RD STE 200
DESOTO, TX 75115-4214
Phone number: 972-226-4261
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Mailing Address
LEE E JACKSON
1229 E PLEASANT RUN RD STE 200
DESOTO, TX 75115-4214
Phone number:
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