Individual
DONCHELLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6547 N BOUVIER ST, PHILADELPHIA, PA 19126-3414
(267) 904-1958
Mailing address
6547 N BOUVIER ST, PHILADELPHIA, PA 19126-3414
(267) 904-1958
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
01/06/2022
Last updated
01/06/2022
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