Individual
TIFFANY MONIQUE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LBS
Contact information
Practice address
3105 ORRIS RD, NORTH VERSAILLES, PA 15137-2213
(412) 510-2274
Mailing address
3105 ORRIS RD, NORTH VERSAILLES, PA 15137-2213
(412) 510-2274
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH007734
PA
106E00000X
Assistant Behavior Analyst
Primary
BH007734
PA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/28/2019
Last updated
04/21/2026
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