Individual
MR. CHRISTOPHER LADD JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MC, LPC, LISAC, NCGC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-11483
AZ
101YP2500X
Professional Counselor
Primary
LPC-12267
AZ
Other
Enumeration date
12/10/2007
Last updated
02/12/2009
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