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Individual
COLLEEN A JACKSON
Active
Individual
COLLEEN A JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
004661
NY
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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