Individual
BREONNA ELODIA GINAVE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7251 W LAKE MEAD BLVD STE 300, LAS VEGAS, NV 89128-8380
(702) 387-2300
Mailing address
7251 W LAKE MEAD BLVD STE 300, LAS VEGAS, NV 89128-8380
(702) 387-2300
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBA0898
NV
Other
Enumeration date
10/31/2019
Last updated
07/10/2024
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