| NPI | 1932591864 |
|---|---|
| Former Name | DOROTHY A. JACKSON REXRODE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPCC.0024252) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2026-02-23 |