Individual
ALIZAY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12505 STARKEY RD STE K, LARGO, FL 33773-2617
(727) 280-6643
Mailing address
12505 STARKEY RD STE K, LARGO, FL 33773-2617
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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