Individual provider · Type 1 NPI
Sandra J. Jackson, LCAC CADAC IV NADAC
Addiction (Substance Use Disorder) Counselor · South Bend, IN
NPI number
1124449053
Active
Practice location
4218 Western Ave.
South Bend, IN 46619
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 88000353A (IN) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1124449053
Sandra J. Jackson, LCAC CADAC IV NADAC's National Provider Identifier is 1124449053, issued on Dec 19, 2013. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in South Bend, IN. The record was last updated on Dec 19, 2013.