John Archie Jackson Valid NPI
Individual provider · Addiction (Substance Use Disorder) Counselor · Elizabethtown, NC
- NPI
- 1801439799
- Type
- Individual (Type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor (Counselor)
- Specialty group
- Behavioral Health & Social Service Providers
- Taxonomy code
- 101YA0400X
- License number
- 1917 (NC)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2019-10-23
- Last updated
- 2019-10-23
Practice location
209 Martin Luther King Dr
Elizabethtown, NC 28337
(910) 247-6822