Individual
BRYON D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAARR
Contact information
Practice address
5930 S MAIN ST, #104, LOS ANGELES, CA 90003-1284
(323) 372-5900
Mailing address
5930 S. MAIN STREET, #104, LOS ANGELES, CA 90003
(323) 372-5900
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/25/2013
Last updated
01/25/2013
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