Individual
MR. DRAEVON EDWARD JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3777 PRIORITY WAY SOUTH DR, INDIANAPOLIS, IN 46240-1491
(317) 574-3980
Mailing address
1927 MONROE ST, INDIANAPOLIS, IN 46229-1921
(317) 772-2830
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
99133860A
IN
Other
Enumeration date
12/23/2025
Last updated
12/23/2025
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