Individual
MRS. ALICIA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RT
Contact information
Practice address
1027 AUDUBON PKWY, LOUISVILLE, KY 40213-1303
(502) 609-3384
Mailing address
1027 AUDUBON PARKWAY, LOUISVILLE, KY 40213
(502) 609-3384
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/02/2008
Last updated
06/02/2008
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