Individual
MS. DEANNA R JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
243 HARTFORD TPK #202, VERNON, CT 06066
(860) 875-1802
Mailing address
PO BOX 586, VERNON, CT 06066-0586
(860) 875-1802
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
000482
CT
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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