Alonzo Jackson LCDC

NPI 1720225113 - Counselor - 101YA0400X

NPI Details
NPI 1720225113
Gender Male
Enumeration Date 01/07/2009
Last Updated 01/07/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
1643 E 2ND ST
AUSTIN TX, 78702-4411, US
Phone (512) 472-4357
Fax (512) 476-0217
Business Location
1430 COLLIER ST
AUSTIN TX, 78704-2911, US
Phone (512) 445-7787
Fax (512) 440-4059
Toxanomy
Taxonomy Code 101YA0400X
License State Texas
License Number 9841
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According to our database, Mr. Alonzo Jackson LCDC NPI is 1720225113, taxonomy code is 101YA0400X and license number is 9841, license state is located at Texas. Alonzo Jackson LCDC physically located at 1643 E 2nd St, Austin TX, 78702-4411. NPI Number Alonzo Jackson LCDC has the Individual type.

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1720225113 NPI number is provided on an as is basis without warranty of any kind. 1720225113 is maintained by the National Plan & Provider Enumeration System. The contents of Alonzo Jackson LCDC are for informational purposes only.