Individual
FAITH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
460 MALL BLVD STE A, SAVANNAH, GA 31406-4891
(912) 244-4031
Mailing address
PO BOX 931142, ATLANTA, GA 31193-4891
(615) 696-6316
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-291536
GA
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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