Individual
SHELON JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2815 W FORD AVE, #1175, LAS VEGAS, NV 89123-6664
(702) 418-6472
Mailing address
2815 W FORD AVE, #1175, LAS VEGAS, NV 89123-6664
(702) 418-6472
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
09/22/2014
Last updated
02/24/2021
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