Individual
REBECCA KEMP JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LCAS-A
Contact information
Practice address
2401 SARDIS RD N STE 120, CHARLOTTE, NC 28227-7722
(704) 336-4844
(704) 227-0691
Mailing address
2401 SARDIS RD N STE 120, CHARLOTTE, NC 28227-7722
(704) 336-4844
(704) 227-0691
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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