Individual
DEJA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2733 E 12TH ST, BROOKLYN, NY 11235-4669
(833) 455-8622
Mailing address
2733 E 12TH ST, BROOKLYN, NY 11235-4669
(833) 455-8622
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/18/2025
Last updated
04/08/2026
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