Individual
AKKIE NATOYA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
39B SCHOOL ST, PISCATAWAY, NJ 08854-5918
(732) 720-3631
Mailing address
39B SCHOOL ST, PISCATAWAY, NJ 08854-5918
(732) 720-3631
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022578
ABA4U
NJ
Enumeration date
04/11/2019
Last updated
04/11/2019
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