Individual
CAROL ANNE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1410 14TH ST, PLANO, TX 75074-6302
(214) 650-6708
(972) 424-2333
Mailing address
437 WOODWAY DR, COPPELL, TX 75019-3354
(972) 762-9916
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-12323
TX
Other
Enumeration date
07/11/2013
Last updated
07/11/2013
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