Individual
RENEE CAMILLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
6515 HOLT RD, NASHVILLE, TN 37211-6903
(615) 832-0059
Mailing address
4716 VENITO ST, MOUNT JULIET, TN 37122-4590
(678) 201-7111
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-31297
TN
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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