| NPI | 1104908417 |
|---|---|
| Other Name | RAYMOND L JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 385HR2055X Respite Care, Respite Care, Mental Illness, Child (Licence: AZ 3923) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2007-07-09 |