Individual
ROBERT JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
615 E 6TH ST, CHARLOTTE, NC 28202-2918
(980) 999-5006
Mailing address
430 N HARDIN ST, SOUTHERN PINES, NC 28387-3139
(704) 258-6366
(855) 345-0943
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23517
NC
Other
Enumeration date
04/16/2020
Last updated
06/09/2020
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