Individual
LYNETTA JEAN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2760 W PEORIA AVE # 1277, PHOENIX, AZ 85029-5202
(626) 339-4999
Mailing address
730 N ATLANTIC ST, COOLIDGE, AZ 85128-3819
(520) 582-8763
(520) 582-8763
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
AZ
Other
Enumeration date
01/19/2026
Last updated
01/20/2026
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