Individual
KELSI M JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1428 44TH ST SW, WYOMING, MI 49509-4312
(616) 604-8492
Mailing address
1428 44TH ST SW, WYOMING, MI 49509-4312
(616) 604-8492
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/22/2019
Last updated
03/22/2025
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