Individual
ALEXIS JACKSON-BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8101 HOLLY LN, CLINTON, MD 20735-3133
(301) 758-8132
Mailing address
1617 30TH ST SE, WASHINGTON, DC 20020-3701
(301) 758-8132
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/17/2023
Last updated
03/17/2023
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