MS. SANDRA JACKSON, LCAC CADAC IV NADAC

Counselor - Addiction (Substance Use Disorder)

Active Individual
NPI: 1124449053

Practice Address

4218 WESTERN AVE.
South Bend, IN 46619

Phone: (574) 233-1524

Specialties

Specialty Code Primary License
Counselor - Addiction (Substance Use Disorder) 101YA0400X Yes 88000353A (IN)

Frequently Asked Questions

NPI 1124449053 is the National Provider Identifier for MS. SANDRA JACKSON, LCAC CADAC IV NADAC, a Counselor - Addiction (Substance Use Disorder) provider located in South Bend, IN. This NPI was enumerated on December 19, 2013.
MS. SANDRA JACKSON, LCAC CADAC IV NADAC practices at 4218 WESTERN AVE., South Bend, IN 46619.

Quick Facts

NPI
1124449053
Type
Individual
Enumerated
Dec 19, 2013
Last Updated
Dec 19, 2013

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