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1831791342
KENITA JACKSON
FARGO, ND
NPI
1831791342
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2020-11-10
Last Update Date
2020-11-10
Business Address
KENITA JACKSON
919 16TH ST N APT E
FARGO, ND 58102-3917
Phone number: 701-205-7323
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Mailing Address
KENITA JACKSON
919 16T ST N ATP E
FARGO, ND 58102
Phone number: 701-205-7323
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