Individual
MONISA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 AIRMOTIVE WAY, SUITE 9, RENO, NV 89502-3201
(775) 357-2623
Mailing address
6748 YELLOWHAMMER PL, NORTH LAS VEGAS, NV 89084-2694
(775) 357-2623
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1405249095
—
NV
Enumeration date
03/06/2017
Last updated
03/06/2017
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