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1932563079
GABRIELLE JACKSON
SANTA ROSA, CA
NPI
1932563079
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Additional Taxonomies
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-04-05
Last Update Date
2018-02-22
Business Address
GABRIELLE JACKSON
2300 NORTHPOINT PKWY
SANTA ROSA, CA 95407-5004
Phone number: 707-571-5581
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Mailing Address
GABRIELLE JACKSON
2300 NORTHPOINT PKWY
SANTA ROSA, CA 95407-5004
Phone number: 707-571-5581
Copy
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