Individual
ALYSSA RAE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
428 THORNHILL LN, LEXINGTON, TN 38351-8116
(731) 798-8244
Mailing address
428 THORNHILL LN, LEXINGTON, TN 38351-8116
(731) 798-8244
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
TN
Other
Enumeration date
04/30/2021
Last updated
04/30/2021
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