Individual
MR. CHAD JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3225 1ST AVE N, BILLINGS, MT 59101-2104
(406) 794-8951
Mailing address
PO BOX 22982, BILLINGS, MT 59104-2982
(406) 794-8951
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
11415
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316329667
—
MT
Enumeration date
06/23/2015
Last updated
02/01/2017
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