Individual
AMBER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 S MOUNT JULIET RD STE 235-118, MT JULIET, TN 37122-6359
(615) 393-1709
Mailing address
2301 SCOTT AVE, NASHVILLE, TN 37216-3119
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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