Individual provider · Type 1 NPI

Russell Earl Jackson

Addiction (Substance Use Disorder) Counselor · Tupelo, MS

NPI number 1164576476 Active

Practice location

920 Boone St
Tupelo, MS 38804-5908

Call (662) 844-3531 Map

Fax (662) 844-1757

Mailing address

PO Box 1943
Verona, MS 38879-1943

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

22 other providers at this address

Other addiction (substance use disorder) counselor providers in Tupelo

See all in Tupelo →

About NPI 1164576476

Russell Earl Jackson's National Provider Identifier is 1164576476, issued on Jan 23, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Tupelo, MS. The record was last updated on Jul 8, 2007.