person
Mr. Russell Earl Jackson
Addiction (Substance Use Disorder) Counselor in Tupelo, Mississippi
NPI 1164576476

Russell Earl Jackson is an Addiction (Substance Use Disorder) Counselor based in Verona, MS and is specialized in Addiction (Substance Use Disorder). Russell Earl Jackson practices in Tupelo, MS. The NPI Number for Russell Earl Jackson is 1164576476 and holds a License No. (Mississippi).

The current practice location address for Russell Earl Jackson is 920 Boone St, Tupelo, MS and can be reached out via phone at 662-844-3531 and via fax at 662-844-1757. You can also correspond with Russell Earl Jackson through the mailing address at PO BOX 1943, VERONA, MS - 38879-1943 (mailing address contact number: 662-566-7969).

Location: 920 Boone St, Tupelo, MS, 38879-1943
person
Provider Profile Details
NPI Number
1164576476
Provider Name
Russell Earl Jackson
Credential
Provider Entity Type
Individual
Gender
Male
Address
920 Boone St, Tupelo, MS, 38879-1943
Phone Number
662-844-3531
Fax Number
662-844-1757
Provider Enumeration Date
01/23/2007
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
920 Boone St
City
State
Zip
38804-5908
Phone Number
662-844-3531
Fax Number
662-844-1757
person
Provider Business Mailing Address Details
Address
920 Boone St
City
State
Zip
38804-5908
Phone Number
662-844-3531
Fax Number
662-844-1757
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
()
Definition
Definition to come...
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