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1194271502
SHEENA N JACKSON
BOWLING GREEN, KY
NPI
1194271502
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
222Q00000X Developmental Therapist
(Licence: KY 201126652)
Enumeration Date
2016-08-27
Last Update Date
2018-08-29
Business Address
SHEENA N JACKSON
303 WHITE DOGWOOD DR
BOWLING GREEN, KY 42101
Phone number: 270-799-8662
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Mailing Address
SHEENA N JACKSON
303 WHITE DOGWOOD DR
BOWLING GREEN, KY 42101-7536
Phone number: 270-799-8662
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