Individual
NAOMI JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1112024
MN
253J00000X
Foster Care Agency
1114922
MN
253Z00000X
In Home Supportive Care Agency
1112024
MN
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
Update your record
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