Individual
JOHN FERNDALE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
931 AZURE HEIGHTS PLACE, LAS VEGAS, NV 89110
(702) 505-3753
Mailing address
931 AZURE HEIGHTS PLACE, LAS VEGAS, NV 89110
(702) 505-3753
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/14/2012
Last updated
06/14/2012
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