Most Relevant Information
Provider Data
| NPI Number: | 1003540360 |
| Provider Name: | JAMES M JACKSON COUNSELOR 3 |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/13/2022 |
| Last Updated: | 07/13/2022 |
Provider Practice Location
2157 GREENBRIER ST
CHARLESTON
WV
253119623
Practice Location Phone/Fax
| Phone: | 3043445924 |
| Fax: | 3043443503 |
Provider Mailing Location
2157 GREENBRIER ST
CHARLESTON
WV
253119623
Provider Mailing Phone/Fax
| Phone: | 3043445924 |
| Fax: | 3043443503 |