Antwoine Jackson
NPI #1922328855 in Shepherdsville, Kentucky
Provider Information
- NPI Number
- 1922328855
- Entity Type
- Individual
- Name
- Antwoine Jackson
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor
- Enumeration Date
- Jun 2, 2010
- Last Updated
- Jun 9, 2011
Practice Location
- Address
- 130 S JOE B HALL AVE
- City
- Shepherdsville
- State
- Kentucky
- ZIP Code
- 40165-0690
- Phone
- (502) 589-8600
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
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