Individual provider · Type 1 NPI
Charley Marie Moore Jackson
Addiction (Substance Use Disorder) Counselor · Blue Ash, OH
NPI number
1659906287
Active
Practice location
9403 Kenwood Rd
Blue Ash, OH 45242-6895
Fax (513) 745-0037
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1659906287
Charley Marie Moore Jackson's National Provider Identifier is 1659906287, issued on Mar 4, 2020. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Blue Ash, OH. The record was last updated on Mar 4, 2020.