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Individual
JOSHUA JACKSON
Active
Individual
JOSHUA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.180460
OH
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
02/24/2021
Last updated
12/05/2022
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