Individual
NOVELLA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
968 DANTZLER ST, ORANGEBURG, SC 29115-4322
(803) 809-0003
(803) 809-0004
Mailing address
968 DANTZLER ST, ORANGEBURG, SC 29115-4322
(803) 809-0003
(803) 809-0004
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
0000001
SC
Other
Enumeration date
04/06/2026
Last updated
04/06/2026
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