Individual
BRIANNE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3101 N CANTERBURY CT, BLOOMINGTON, IN 47404-1500
(317) 249-2242
(317) 663-1175
Mailing address
550 CONGRESSIONAL BLVD STE 220, CARMEL, IN 46032-5632
(317) 249-2242
(317) 663-1175
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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