| NPI | 1083097265 |
|---|---|
| Former Name | MAYRA JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 372600000X Adult Companion |
| Additional Taxonomies | 101Y00000X Counselor |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2025-05-02 |