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Individual
CHARLIE JACKSON
Active
Individual
CHARLIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RMHCI
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IMH16970
FL
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/24/2013
Last updated
04/11/2018
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