Individual provider · Type 1 NPI
Nicole Jackson
Substance Use Disorder Rehabilitation Clinic/Center · Smithtown, NY
NPI number
1972977825
Active
Practice location
11 Route 111
Smithtown, NY 11787-3753
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center Primary | 261QR0405X | 089076 (NY) |
Substance Use Disorder Rehabilitation Clinic/Center: Definition to come...
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- Amanda NortonCase Manager/Care Coordinator Smithtown, NY NPI 1114323383
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About NPI 1972977825
Nicole Jackson's National Provider Identifier is 1972977825, issued on Nov 16, 2015. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Smithtown, NY. The record was last updated on Nov 16, 2015.