Individual
CRADEJA SHOVON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
715 KING AVE, FLORENCE, SC 29501-4332
(843) 319-7055
Mailing address
715 KING AVE, FLORENCE, SC 29501-4332
(843) 319-7055
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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