Individual
DESSIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1950 DOCTORS PARK DR, COLUMBUS, IN 47203-2375
(812) 373-6103
(888) 375-4149
Mailing address
1950 DOCTORS PARK DR, COLUMBUS, IN 47203-2375
(812) 373-6103
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
95000968A
IN
106S00000X
Behavior Technician
Primary
RBT-21-156021
IN
Other
Enumeration date
11/09/2021
Last updated
04/27/2026
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