Individual
VELMA J. JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
413 E DIXIE AVE STE 106, ELIZABETHTOWN, KY 42701-1162
(270) 319-9899
Mailing address
413 E DIXIE AVE STE 106, ELIZABETHTOWN, KY 42701-1162
(270) 319-9899
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
241831
KY
Other
Enumeration date
04/01/2020
Last updated
04/01/2020
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