Antoinette Rae Jackson

NPI #1144196387 in Milwaukee, Wisconsin

Provider Information

NPI Number: 1144196387
Entity Type: Individual
Name: Antoinette Rae Jackson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Oct 15, 2025
Last Updated: Oct 15, 2025

Practice Location

Address: 3925 N 6TH ST
City: Milwaukee
State: Wisconsin
ZIP Code: 53212-1139
Phone: (414) 234-7720

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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