Individual
MINDY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1540 COUNTRY CLUB RD, SHERWOOD, AR 72120-5095
(501) 753-5459
(501) 753-5463
Mailing address
1540 COUNTRY CLUB RD, SHERWOOD, AR 72120-5095
(501) 753-5459
(501) 753-5463
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-74438
AR
106S00000X
Behavior Technician
RBT-21-150148
AR
Other
Enumeration date
11/10/2021
Last updated
07/30/2024
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