NICOLE JACKSON

SMITHTOWN, NY
NPI1972977825
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder
(Licence: NY  089076)
Enumeration Date2015-11-16
Last Update Date2015-11-16
Business Address
Miss NICOLE JACKSON
11 ROUTE 111
SMITHTOWN, NY 11787-3753
Phone number: 631-920-8300
Mailing Address
Miss NICOLE JACKSON
11 ROUTE 111
SMITHTOWN, NY 11787-3753
Phone number: 631-920-8300
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