Individual
MARY KAITLYN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2815 LONGVIEW DR, JONESBORO, AR 72401-5919
(870) 842-3274
Mailing address
119 WILLIAMSBURG RD, WALNUT RIDGE, AR 72476-8477
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12580290
AR
Other
Enumeration date
09/25/2025
Last updated
09/25/2025
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