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1982114344
JACKIE JEROME JOHNSON
LUBBOCK, TX
NPI
1982114344
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-10-11
Last Update Date
2017-10-11
Business Address
Mr. JACKIE JEROME JOHNSON LCDC-I
1715 26TH ST
LUBBOCK, TX 79411-1524
Phone number: 806-780-8300
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Mailing Address
Mr. JACKIE JEROME JOHNSON LCDC-I
1715 26TH ST
LUBBOCK, TX 79411-1524
Phone number: 806-780-8300
Copy
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