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1902580509
SUSAN NICOLE JACKSON
LAS VEGAS, NV
NPI
1902580509
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NV 07309-I)
Enumeration Date
2023-06-14
Last Update Date
2023-06-14
Business Address
SUSAN NICOLE JACKSON CADC-1
2887 S MARYLAND PKWY
LAS VEGAS, NV 89109-1511
Phone number: 702-747-4104
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Mailing Address
SUSAN NICOLE JACKSON CADC-1
4929 CASCADE POOLS AVE
LAS VEGAS, NV 89131-3627
Phone number: 559-477-2907
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