Individual
JAKERA BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
119 CANE CREEK BLVD, DANVILLE, VA 24540-5609
(704) 824-4999
Mailing address
2675 COURT DR, GASTONIA, NC 28054-1478
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/23/2024
Last updated
03/18/2025
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