Individual
INGRID JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT, CHW, C.HT.
Contact information
Practice address
7261 W CHARLESTON BLVD STE 101, LAS VEGAS, NV 89117-1679
(702) 396-0101
(702) 222-0212
Mailing address
7261 W CHARLESTON BLVD STE 101, LAS VEGAS, NV 89117-1679
(702) 396-0101
(702) 215-5801
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
25728486
NV
Other
Enumeration date
07/24/2018
Last updated
10/09/2020
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