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Individual

DR. BEVERLY P JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
Ň.D.

Contact information

Practice address
19 SILK ST, NORWALK, CT 06850-2916
(203) 962-2995
Mailing address
19 SILK ST, NORWALK, CT 06850-2916
(203) 962-2995

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
ND00001 FEDERAL LIC.

Other

Enumeration date
04/08/2010
Last updated
06/12/2016
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