Individual
JULIA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
828 WAPPOO RD, CHARLESTON, SC 29407-5865
(843) 297-8470
Mailing address
14 ELMWOOD ST, CHARLESTON, SC 29403-4335
(843) 830-7760
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/27/2023
Last updated
02/27/2023
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