Individual
JACQUELINE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14 W MAIN ST, 320, THOMASVILLE, NC 27360-3935
(336) 313-3088
(866) 505-8970
Mailing address
14 W MAIN ST, 320, THOMASVILLE, NC 27360-3935
(336) 313-3088
(866) 505-8970
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
HC4848
NC
374U00000X
Home Health Aide
HC4848
NC
Other
Enumeration date
08/14/2016
Last updated
08/14/2016
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