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1902074545
TRACEY JACKSON
WILMINGTON, DE
NPI
1902074545
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2008-02-18
Last Update Date
2008-02-18
Business Address
-- TRACEY JACKSON
2814 W 2ND ST
WILMINGTON, DE 19805-1807
Phone number: 302-472-0381
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Mailing Address
-- TRACEY JACKSON
2814 W 2ND ST
WILMINGTON, DE 19805-1807
Phone number: 302-472-0381
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