Individual
MR. DAVID WAYNE JACKSON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, BCBA
Contact information
Practice address
5526 N ACADEMY BLVD STE 109, COLORADO SPRINGS, CO 80918-3688
(719) 301-5100
(719) 960-2649
Mailing address
5526 N ACADEMY BLVD STE 109, COLORADO SPRINGS, CO 80918-3688
(719) 301-5100
(719) 960-2649
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-22915
TX
Other
Enumeration date
09/08/2016
Last updated
11/19/2020
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