Individual
CONNOR JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
1455 OLD ALABAMA RD STE 195, ROSWELL, GA 30076-2129
(678) 940-1367
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-337234
GA
Other
Enumeration date
03/29/2024
Last updated
03/29/2024
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