Individual
JAELYN TAYLOR JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
923 GARDENS BLVD, CHARLOTTESVILLE, VA 22901-1472
(844) 244-1818
Mailing address
208 APPLE ORCHARD RD, LOUISA, VA 23093-4936
(443) 933-0060
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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