Individual
LAKIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9700 W CAPITOL DR APT 1, MILWAUKEE, WI 53222-1468
(414) 378-0268
Mailing address
9700 W CAPITOL DR APT 1, MILWAUKEE, WI 53222-1468
(414) 378-0268
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
06/06/2019
Last updated
06/06/2019
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