| NPI | 1134699481 |
|---|---|
| Former Name | ANITA DIONNE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: FL 30212414) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2022-07-12 |