Individual
LATREESE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2049 AMBER SWEET CIR, DUNDEE, FL 33838-4271
(407) 701-8201
Mailing address
2049 AMBER SWEET CIR, DUNDEE, FL 33838-4271
(407) 701-8201
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
03/17/2015
Last updated
11/29/2022
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