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1891897708
CHARLES ANTHONY JACKSON
GREENVILLE, SC
NPI
1891897708
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2006-09-01
Last Update Date
2007-07-08
Business Address
-- CHARLES ANTHONY JACKSON
124 MALLARD STREET
GREENVILLE, SC 29601-4046
Phone number: 864-241-1044
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Mailing Address
-- CHARLES ANTHONY JACKSON
124 MALLARD STREET
GREENVILLE, SC 29601-4046
Phone number: 864-241-1044
Copy
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