TERRY JACKSON

PHOENIX, AZ
NPI1235569849
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy385HR2055X Respite Care, Respite Care, Mental Illness, Child
(Licence: AZ  5167765)
Enumeration Date2013-11-18
Last Update Date2013-11-18
Business Address
-- TERRY JACKSON
6605 S 18TH DR
PHOENIX, AZ 85041-5841
Phone number: 989-714-8157
Mailing Address
-- TERRY JACKSON
6605 S 18TH DR
PHOENIX, AZ 85041-5841
Phone number: 989-714-8157
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