Individual provider · Type 1 NPI

John Mark Jackson

Addiction (Substance Use Disorder) Counselor · Pueblo, CO

NPI number 1235779166 Active

Practice location

3470 Baltimore Ave
Pueblo, CO 81008-1520

Call (719) 545-1181 Map

Mailing address

208 Circle Dr W
Canon City, CO 81212-2439

Specialties and licenses

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

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

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About NPI 1235779166

John Mark Jackson's National Provider Identifier is 1235779166, issued on Jan 8, 2020. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Pueblo, CO. The record was last updated on Jan 8, 2020.