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1194197210
KIQIANA JACKSON
CHICAGO, IL
NPI
1194197210
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
222Q00000X Developmental Therapist
Enumeration Date
2015-10-28
Last Update Date
2015-12-01
Business Address
-- KIQIANA JACKSON
8808 S HERMITAGE AVE
CHICAGO, IL 60620-4940
Phone number: 773-656-8638
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Mailing Address
-- KIQIANA JACKSON
8808 S HERMITAGE AVE
CHICAGO, IL 60620-4940
Phone number: 773-656-8638
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