Individual
DIANE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
981 W SIMKINS RD, PAHRUMP, NV 89060-2688
(775) 209-1123
Mailing address
981 W SIMKINS RD, PAHRUMP, NV 89060-2688
(775) 209-1123
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/25/2014
Last updated
04/25/2014
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