Individual
ALEXA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3361 36TH ST SE, KENTWOOD, MI 49512-2809
(616) 726-1909
Mailing address
3361 36TH ST SE, KENTWOOD, MI 49512-2809
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/23/2022
Last updated
11/23/2022
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