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NPI Profile for DOROTHY J JACKSON in LAS VEGAS, NV.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adult Day Care |
261QA0600X |
| NPI Number | 1407364169 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 01/16/2018 | |
| Last updated | 01/16/2018 - About 8 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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DOROTHY J JACKSON
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DOROTHY J JACKSON