Individual
AUTUMN A JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5001 SILVER HILL RD STE 101, SUITLAND, MD 20746-5215
(484) 965-9966
Mailing address
640 FREEDOM BUSINESS CTR DR STE 220, KING OF PRUSSIA, PA 19406-1376
(484) 965-9966
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MD
Other
Enumeration date
05/27/2026
Last updated
05/27/2026
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