KEILON LATRICE JACKSON

LAWRENCEVILLE, GA
NPI1285852764
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy374U00000X Home Health Aide
(Licence: GA  20019336068)
Additional Taxonomies372600000X Adult Companion
(Licence: GA  20019336068)
376K00000X Nurse's Aide
(Licence: GA  20019336068)
Enumeration Date2007-04-23
Last Update Date2012-01-05
Business Address
Miss KEILON LATRICE JACKSON CMA
511 DOWNING ST
LAWRENCEVILLE, GA 30045-4597
Phone number: 678-577-9097
Mailing Address
Miss KEILON LATRICE JACKSON CMA
511 DOWNING ST
LAWRENCEVILLE, GA 30045-4597
Phone number: 678-577-9097