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Individual

CINTORRA JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
602 TALLMAN AVE, DONALSONVILLE, GA 39845-1734
(850) 427-3079
Mailing address
PO BOX 5812, MARIANNA, FL 32447-5812
(850) 427-3079

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-248839
FL

Other

Enumeration date
12/14/2022
Last updated
12/14/2022
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