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Individual

JAKIA JANESE PEARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
219 MULBERRY ST, SLOCOMB, AL 36375-6601
(334) 435-1384
Mailing address
219 MULBERRY ST, SLOCOMB, AL 36375-6601
(334) 435-1384

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RBT-22-200083
RBT-22-200083
Enumeration date
02/17/2022
Last updated
02/17/2022
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