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Individual

STEVEN JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CAC

Contact information

Practice address
27 NAEK RD STE 4, VERNON, CT 06066-3965
(860) 872-9835
(860) 870-9384
Mailing address
27 NAEK RD STE 4, VERNON, CT 06066-3965
(860) 872-9835

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
08/03/2022
Last updated
08/03/2022
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