Individual
MRS. ELENA PATRICIA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
703 ANGELIQUE CT, LANOKA HARBOR, NJ 08734-2231
(609) 971-5348
(609) 971-0827
Mailing address
703 ANGELIQUE CT, LANOKA HARBOR, NJ 08734-2231
(609) 971-5348
(609) 971-0827
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
40QA00951400
NJ
Other
Enumeration date
07/11/2008
Last updated
07/11/2008
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