Individual
MARCUS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1638 MAPLE AVE, EVANSTON, IL 60201-3602
(866) 815-6592
Mailing address
7312 N GREENVIEW AVE APT 3, CHICAGO, IL 60626-2451
(517) 219-7776
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/07/2023
Last updated
12/07/2023
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