MISS Amani Dianne Jackson

NPI #1962864447 in Matteson, Illinois

Provider Information

NPI Number: 1962864447
Entity Type: Individual
Name: MISS Amani Dianne Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Mar 24, 2016
Last Updated: Mar 24, 2016

Practice Location

Address: 3631 213TH ST
City: Matteson
State: Illinois
ZIP Code: 60443-2510
Phone: (708) 724-4170

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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