Individual
MISS KRISTIN RASHAWN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
401 S MOUNT JULIET RD STE 235-118, MT JULIET, TN 37122-6359
(703) 506-0123
Mailing address
8578 BAY ORCHARD LN, CORDOVA, TN 38018-1031
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
19-83620
TN
Other
Enumeration date
01/21/2022
Last updated
01/21/2022
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