Individual
MRS. MARISSA CAYENNE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
212 S UNIVERSITY AVE, CARBONDALE, IL 62901-2925
(618) 534-9222
Mailing address
1412 MOUNDS RD, MOUNDS, IL 62964-2305
(618) 759-0890
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
MJ25
IL
Other
Enumeration date
07/23/2025
Last updated
07/23/2025
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