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1639300874
KEWUAN DESHAUN JACKSON
TUCSON, AZ
NPI
1639300874
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
385HR2055X Respite Care Respite Care, Mental Illness, Child
(Licence: AZ 1490923)
Enumeration Date
2009-08-05
Last Update Date
2009-08-05
Business Address
KEWUAN DESHAUN JACKSON
4880 N SABINO CANYON RD APT 14160
TUCSON, AZ 85750-7006
Phone number: 520-818-4318
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Mailing Address
KEWUAN DESHAUN JACKSON
4880 N SABINO CANYON RD APT 14160
TUCSON, AZ 85750-7006
Phone number: 520-818-4318
Copy
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