Desiree Jackson
NPI #1699150268 in North Baldwin, New York
Provider Information
- NPI Number
- 1699150268
- Entity Type
- Individual
- Name
- Desiree Jackson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Early Intervention Provider Agency
- Enumeration Date
- Jul 24, 2015
- Last Updated
- Jul 24, 2015
Practice Location
- Address
- 2127 MARION PL
- City
- North Baldwin
- State
- New York
- ZIP Code
- 11510-2921
- Phone
- (646) 739-0985
Specialties & Taxonomy Codes
| Specialty |
|---|
| Early Intervention Provider Agency |
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