| NPI | 1437373594 |
|---|---|
| Former Name | TAMECA NICOLE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW15080) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC50078319) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-12-21 |