Individual
CHARITY NICOLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BACHELORS
Contact information
Practice address
4075 PARK AVE, MEMPHIS, TN 38111-7400
(901) 584-8281
Mailing address
4075 PARK AVE, MEMPHIS, TN 38111-7400
(901) 584-8281
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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