Individual
EBONY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12158 ALEXANDRA DR, JACKSONVILLE, FL 32218-8883
(904) 502-1294
Mailing address
12158 ALEXANDRA DR, JACKSONVILLE, FL 32218-8883
(904) 502-1294
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
02/25/2019
Last updated
02/25/2019
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