Individual
CARRIE RAE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
10715 BABCOCK BLVD, GIBSONIA, PA 15044-8977
(412) 498-9128
(724) 502-4510
Mailing address
10715 BABCOCK BLVD, GIBSONIA, PA 15044-8977
(412) 498-9128
(724) 502-4510
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
1-05-2589
PA
Other
Enumeration date
01/26/2012
Last updated
01/26/2012
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