Individual
MRS. SHARON DENISE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS RD CDE
Contact information
Practice address
1425 BLUE HILLS AVE, MATTAPAN COMMUNITY HEALTH CTR, MATTAPAN, MA 02126
(617) 898-9052
(617) 713-3438
Mailing address
6 NEWCROFT CIRCLE, MATTAPAN, MA 02126
(617) 296-3987
(617) 713-3438
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
1031
MA
Other
Enumeration date
11/13/2006
Last updated
07/08/2007
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