Individual
THOMAS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1161 LAKE COOK RD, DEERFIELD, IL 60015-5649
(224) 284-2240
Mailing address
1161 LAKE COOK RD, DEERFIELD, IL 60015-5649
(224) 284-2240
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-22-250675
—
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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