| NPI | 1124614300 |
|---|---|
| Professional Name | NICOLE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CA 80148) |
| Additional Taxonomies | 174H00000X Health Educator |
| Enumeration Date | 2020-12-12 |
| Last Update Date | 2020-12-12 |