Individual
MR. JUSTIN ALBERT JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPRS
Contact information
Practice address
393 MAIN ST, PATERSON, NJ 07501-2815
(973) 523-6220
Mailing address
99 MARKET ST APT 3, PATERSON, NJ 07505-1235
(973) 390-7089
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CPRS-50177
NJ
Other
Enumeration date
04/20/2022
Last updated
04/20/2022
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