Individual
MRS. SHANIQUA JANORIA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
36 RAMONA COLLINS CT, CAMERON, NC 28326-6667
(912) 809-8713
Mailing address
36 RAMONA COLLINS CT, CAMERON, NC 28326-6667
(912) 809-8713
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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