Jackson, Anquanette

Jackson, Anquanette is an individual health care provider with primary practice located at 2400 S Ridgewood Ave , South Daytona FL 32119-3097. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Jackson, Anquanette can be contacted via phone (305) 928-0167.

Contact Information

Primary practice address
2400 S Ridgewood Ave South Daytona FL 32119-3097
Phone: (305) 928-0167
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1679087282
LBN Legal business name Jackson, Anquanette
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 20th, 2017
Last updated Mar 17th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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