Individual
MS. ADRIAENNA JACKSON-ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 DUDLEY ST, ROXBURY, MA 02119-2769
(617) 785-7723
(617) 445-2672
Mailing address
520 DUDLEY ST, ROXBURY, MA 02119-2769
(617) 785-7723
(617) 445-2672
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25725
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043082352
MASS HEALTH -MBHP
MA
Enumeration date
10/19/2015
Last updated
11/10/2015
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