Individual
AMANDA SUE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 SWANNANOA RIVER RD, ASHEVILLE, NC 28805-2216
(857) 829-4040
Mailing address
84 JACK SULLINS RD, SPRUCE PINE, NC 28777-8450
(828) 467-2206
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/09/2024
Last updated
08/15/2024
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