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1952157984
EMILY JACKSON
RAPID CITY, SD
NPI
1952157984
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: SD 17091765)
Enumeration Date
2024-04-29
Last Update Date
2024-04-29
Business Address
EMILY JACKSON LAC
308 QUINCY ST
RAPID CITY, SD 57701-2813
Phone number: 605-391-4863
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Mailing Address
EMILY JACKSON LAC
308 QUINCY ST
RAPID CITY, SD 57701-2813
Phone number: 605-391-4863
Copy
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