Individual
TASIA KIARA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4464 PARKTON DR, CLEVELAND, OH 44128-3532
(216) 659-1714
Mailing address
4464 PARKTON DR, CLEVELAND, OH 44128-3532
(216) 659-1714
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
—
OH
376K00000X
Nurse's Aide
Primary
602669220623
OH
Other
Enumeration date
07/06/2024
Last updated
07/08/2024
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