Individual
BIANCA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2655 E DEER SPRINGS WAY APT 2085, NORTH LAS VEGAS, NV 89086-1466
(702) 301-6867
Mailing address
2655 E DEER SPRINGS WAY APT 2085, NORTH LAS VEGAS, NV 89086-1466
(702) 301-6867
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
08/24/2011
Last updated
08/24/2011
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