Individual
CIERRA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
903 PARKVIEW CIR, HEWITT, TX 76643-3265
(903) 312-1315
(866) 790-8027
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(855) 832-6727
(772) 675-9100
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-45413
TX
106S00000X
Behavior Technician
RBT-18-49068
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-20-45413
BACB
TX
01
—
RBT-18-49068
BACB
TX
Enumeration date
02/06/2018
Last updated
03/30/2023
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