Individual
MR. ERIC GREGORY JACKLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAC, ICADC, MS, LADC
Contact information
Practice address
1789 NEW BRITAIN AVE, FARMINGTON, CT 06032-3317
(860) 754-3507
Mailing address
1789 NEW BRITAIN AVE, FARMINGTON, CT 06032-3317
(860) 754-3507
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
12/18/2020
Last updated
02/17/2023
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