Individual
LEE E JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1229 E PLEASANT RUN RD STE 200, DESOTO, TX 75115-4214
(972) 226-4261
Mailing address
1229 E PLEASANT RUN RD STE 200, DESOTO, TX 75115-4214
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13217
TX
Other
Enumeration date
07/20/2021
Last updated
07/20/2021
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