Individual
DIANNA E JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4656 SAINT FRANCIS AVE APT 411, DALLAS, TX 75227-1898
(214) 515-2585
Mailing address
4656 SAINT FRANCIS AVE APT 411, DALLAS, TX 75227-1898
(214) 515-2585
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
134447
TX
Other
Enumeration date
04/06/2022
Last updated
04/06/2022
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