Individual
ANGEL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2313 BANYAN LAKE CIR, WEST PALM BEACH, FL 33415-2678
(561) 541-6722
Mailing address
3200 SUMMIT BLVD, 16421, WEST PALM BEACH, FL 33416-4001
(561) 541-6722
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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