Individual
INGRID ANN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
2698 CONNESTEE TRL, BREVARD, NC 28712-7405
(828) 877-2090
Mailing address
2698 CONNESTEE TRL, BREVARD, NC 28712-7405
(828) 877-2090
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6965
NC
Other
Enumeration date
01/24/2008
Last updated
01/24/2008
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