Individual
CHERRON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 FISHFRY ST, HARTFORD, CT 06120-1203
(860) 247-8300
Mailing address
55 FISHFRY ST, HARTFORD, CT 06120-1203
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/04/2016
Last updated
02/23/2016
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