Individual
ANTOINETTE S JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 W OAKEY BLVD STE A3-4, LAS VEGAS, NV 89146-0391
(702) 377-1198
Mailing address
3840 N COMMERCE ST, SUITE 100, NORTH LAS VEGAS, NV 89032-8104
(702) 649-5995
(702) 399-9801
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
—
—
3747P1801X
Personal Care Attendant
Primary
1404123254
NV
Other
Enumeration date
12/19/2012
Last updated
08/18/2022
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