Individual
JAMILA SHANI JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2762 COLONIAL DR, COLLEGE PARK, GA 30337-4845
(678) 974-9493
Mailing address
2762 COLONIAL DR, COLLEGE PARK, GA 30337-4845
(678) 974-9493
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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