Individual
NADINE YVETTE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
1751 PARK AVE, NEW YORK, NY 10035-2809
(212) 991-4994
(212) 414-1431
Mailing address
141 W 128TH ST APT 7, NEW YORK, NY 10027-3027
(646) 657-0063
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2-11436
NY
Other
Enumeration date
07/24/2017
Last updated
07/24/2017
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