DOMINIQUE SHAVANTA JACKSON

CLEVELAND, OH
NPI1689426793
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy175T00000X Peer Specialist
(Licence: OH  APS.005574)
Additional Taxonomies171M00000X Case Manager/Care Coordinator
372600000X Adult Companion
376K00000X Nurse's Aide
Enumeration Date2024-04-02
Last Update Date2024-12-02
Business Address
DOMINIQUE SHAVANTA JACKSON
4114 E 141ST ST
CLEVELAND, OH 44128-1806
Phone number: 216-501-3289
Mailing Address
DOMINIQUE SHAVANTA JACKSON
4114 E 141ST ST
CLEVELAND, OH 44128-1806
Phone number: 216-501-3289