Individual
MAURICE D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
6985 NEXUS CT STE 107, FAYETTEVILLE, NC 28304-3186
(910) 728-4449
Mailing address
1623 BINGHAM DR, FAYETTEVILLE, NC 28304-5529
(850) 294-8267
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1790129740
NC
Other
Enumeration date
12/29/2017
Last updated
12/29/2017
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