Individual
TIARA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3064 STANTON RD SE, WASHINGTON, DC 20020-7888
(202) 678-1715
Mailing address
5027 C ST SE APT 204, WASHINGTON, DC 20019-7686
(202) 904-8983
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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