Individual
MS. ASHIYA FAYE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, PCS
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
070010961
IL
Other
Enumeration date
03/05/2007
Last updated
01/12/2022
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