Individual
MS. RACHEL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
3256 SKY VIEW DR, BOX 4323, WEST WENDOVER, NV 89883-3659
(801) 651-4407
Mailing address
PO BOX 4323, WEST WENDOVER, NV 89883-4323
(801) 651-4407
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-13032
CO
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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