Organization
TRANSFORMATION HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATICIA JACKSON MPH. CPT, CLWMS (OWNER)
(850) 696-8069
Entity
Organization
Contact information
Practice address
4400 BAYOU BLVD STE 47-B3, PENSACOLA, FL 32503-2673
(850) 696-8069
Mailing address
4051 E OLIVE RD APT 274, PENSACOLA, FL 32514-6445
(850) 696-8069
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
06/22/2016
Last updated
06/22/2016
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