JACKIE JEROME JOHNSON

LUBBOCK, TX
NPI1982114344
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2017-10-11
Last Update Date2017-10-11
Business Address
Mr. JACKIE JEROME JOHNSON LCDC-I
1715 26TH ST
LUBBOCK, TX 79411-1524
Phone number: 806-780-8300
Mailing Address
Mr. JACKIE JEROME JOHNSON LCDC-I
1715 26TH ST
LUBBOCK, TX 79411-1524
Phone number: 806-780-8300