Male or Other

Willie Jackson Ii

Day Training/Habilitation Specialist in Jacksonville, FL(View on Map)

Full Name

Willie Jackson Ii

NPI Number

1700995792

NPI Type

Individual Provider

Gender

Male

Enumeration Date

08/30/2006

Specialties

(Taxonomies)

Code

373H00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

1860 MEMORY LN
1860 MEMORY LN

City

Jacksonville
Jacksonville

State

FL
FL

Postal Code

32210-1308
32210-1308

Country

US
US

Telephone Number

(904) 265-0340
(904) 265-0340

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

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