Ricardo Jackson CASAC

NPI 1629159967 - Counselor - 101YA0400X

NPI Details
NPI 1629159967
Gender Male
Enumeration Date 10/17/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
175 REMSEN ST
10TH FLOOR
BROOKLYN NY, 11201-4300, US
Phone (718) 852-5552
Fax (718) 852-5666
Business Location
175 REMSEN ST
10TH FLOOR
BROOKLYN NY, 11201-4300, US
Phone (718) 852-5552
Fax (718) 852-5666
Toxanomy
Taxonomy Code 101YA0400X
License State New York
License Number 6092
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According to our database, Ricardo Jackson CASAC NPI is 1629159967, taxonomy code is 101YA0400X and license number is 6092, license state is located at New York. Ricardo Jackson CASAC physically located at 175 Remsen St, Brooklyn NY, 11201-4300. NPI Number Ricardo Jackson CASAC has the Individual type.

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1629159967 NPI number is provided on an as is basis without warranty of any kind. 1629159967 is maintained by the National Plan & Provider Enumeration System. The contents of Ricardo Jackson CASAC are for informational purposes only.