| NPI | 1255701546 |
|---|---|
| Other Name | TLIFFANY NICOLE MORTON JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL3652) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2015-09-30 |