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1962647107
MICHAEL SCOTT JACKSON
WHITE CITY, OR
NPI
1962647107
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2008-12-02
Last Update Date
2024-10-09
Business Address
MICHAEL SCOTT JACKSON
8495 CRATER LAKE HWY
WHITE CITY, OR 97503-3011
Phone number: 541-826-2111
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Mailing Address
MICHAEL SCOTT JACKSON
415 PLACER ST
ROGUE RIVER, OR 97537-9516
Phone number: 661-886-9444
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