Individual
TABISHA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
157 CHURCH ST FL 19, NEW HAVEN, CT 06510-2100
(203) 584-6033
Mailing address
157 CHURCH ST FL 19, NEW HAVEN, CT 06510-2100
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
21161Y05
CT
Other
Enumeration date
10/20/2022
Last updated
10/20/2022
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