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1942993795
LADALE B JACKSON
LOS ANGELES, CA
NPI
1942993795
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-05-30
Last Update Date
2023-05-30
Business Address
LADALE B JACKSON
5723 WHITTIER BLVD
LOS ANGELES, CA 90022-4222
Phone number: 323-721-6855
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Mailing Address
LADALE B JACKSON
5231 ROSELAND ST APT 4
LOS ANGELES, CA 90016-3459
Phone number: 424-944-0169
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