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Carol Denise Jackson, ACADC

Counselor, Addiction (Substance Use Disorder) in Des Moines, IA. Individual provider (NPI-1).

NPI number1487980652
StatusActive
Last updated in NPPESOct 23, 2009

Details

NPI
1487980652
Entity type
Individual (NPI-1)
Name
Mrs. Carol Denise Jackson
Credential
ACADC
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 23, 2009
Last updated
Oct 23, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YA0400X Counselor, Addiction (Substance Use Disorder)92151IAYes

Practice location

1522 17th Street
Des Moines, IA 50314-0000

Phone 515-279-0335

Mailing address

1522 17th St
Des Moines, IA 50314-1418

Phone 515-279-0335

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