| NPI | 1710519293 |
|---|---|
| Professional Name | LESTINE VIRGINIA JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: DC IIII) |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2020-02-12 |