Individual
JACKSON ADONIS GREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1294 18TH ST E, HASTINGS, MN 55033-3680
(651) 888-4462
Mailing address
1294 18TH ST E, HASTINGS, MN 55033-3680
(651) 888-4462
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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