Individual
MISS SHAYLEE BREANNE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
147 W JOHN ST APT 3, BEDFORD, PA 15522-1720
(304) 702-2420
Mailing address
147 W JOHN ST APT 3, BEDFORD, PA 15522-1720
(304) 702-2420
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH008453
PA
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/11/2022
Last updated
04/30/2026
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