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Organization
JACKSON AUTISM CENTER
Active
Organization
JACKSON AUTISM CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA MULLICAN PHD (BEHAVIOR INTERVENTIONIST)
(769) 218-9596
Entity
Organization
Contact information
Practice address
314 COLONIAL CIR, JACKSON, MS 39211-4213
(769) 218-9596
Mailing address
314 COLONIAL CIR, JACKSON, MS 39211-4213
(769) 218-9596
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
02/19/2013
Last updated
02/19/2013
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