| NPI | 1336390772 |
|---|---|
| Former Name | PAMELA L JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: MN 17861) |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2008-10-03 |