NPI 1063838878
Shirley McMillan Jackson
Practice location
- Address
- 2117 Luckner CT, Mobile, AL 36618-2618
- Phone
- (251) 423-8197
- Fax
- (251) 452-4797
- Mailing address
- 410 S Wilson Ave, Prichard, AL 36610-3910
Registered specialties
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
Registry record
- NPI
- 1063838878
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 17 Mar 2014
- Record last updated
- 17 Mar 2014
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.