Leo B Jackson CCDC

NPI 1154524585 - Counselor - 101Y00000X

NPI Details
NPI 1154524585
Gender Male
Enumeration Date 06/05/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
3756 SANTA ROSALIA DR STE 507
LOS ANGELES CA, 90008-3656, US
Phone (323) 290-2001
Fax (323) 209-2003
Business Location
3756 SANTA ROSALIA DR STE 507
LOS ANGELES CA, 90008-3656, US
Phone (323) 290-2001
Fax (323) 209-2003
Toxanomy
Taxonomy Code 101Y00000X
License State
License Number
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According to our database, Mr. Leo B Jackson CCDC NPI is 1154524585, taxonomy code is 101Y00000X Leo B Jackson CCDC physically located at 3756 Santa Rosalia Dr Ste 507, Los Angeles CA, 90008-3656. NPI Number Leo B Jackson CCDC has the Individual type.

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1154524585 NPI number is provided on an as is basis without warranty of any kind. 1154524585 is maintained by the National Plan & Provider Enumeration System. The contents of Leo B Jackson CCDC are for informational purposes only.