Individual
MRS. ANDE M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,CNC
Contact information
Practice address
219 LAKE CIRCLE DR, GREENVILLE, SC 29609-6623
(864) 849-0279
Mailing address
219 LAKE CIRCLE DR, GREENVILLE, SC 29609-6623
(864) 849-0279
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Enumeration date
04/08/2007
Last updated
07/08/2007
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