Individual
JOLIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN, LD
Contact information
Practice address
2302 COLLEGE AVE, CONWAY, AR 72034-6297
(501) 513-5248
Mailing address
2302 COLLEGE AVE, CONWAY, AR 72034-6297
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86198172
AR
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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