Individual
JOANNE KELLY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A,B.A.,CADC 1
Contact information
Practice address
205 SE 3RD AVE, HILLSBORO, OR 97123-4093
(503) 693-3104
Mailing address
205 SE 3RD AVE, HILLSBORO, OR 97123-4093
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/23/2007
Last updated
03/07/2008
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