Individual
TASHA M JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3843 N GUY RD, POST FALLS, ID 83854-9332
(208) 691-3375
Mailing address
3843 N GUY RD, POST FALLS, ID 83854-9332
(208) 691-3375
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/20/2023
Last updated
04/20/2023
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