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1043556939
MAVIS VICTORIA JACKSON
POMPANO BEACH, FL
NPI
1043556939
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
222Q00000X Developmental Therapist
Enumeration Date
2012-12-20
Last Update Date
2012-12-20
Business Address
-- MAVIS VICTORIA JACKSON
2708 NE 14TH ST SUITE 5
POMPANO BEACH, FL 33062-3565
Phone number: 888-880-9279
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Mailing Address
-- MAVIS VICTORIA JACKSON
33050 SW 187TH AVE
FLORIDA CITY, FL 33034-1611
Phone number: 305-967-3593
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