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Individual

MS. JALEESA JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
228 SELMA AVE, SELMA, AL 36701-5825
(334) 877-1490
(334) 877-1491
Mailing address
101 PARK PL, SELMA, AL 36701-6764
(334) 407-1946
(334) 874-7435

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
AL

Other

Enumeration date
12/18/2019
Last updated
12/18/2019
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