Individual
ALYSA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
7108 S KANNER HWY, STUART, FL 34997-7462
(772) 349-6317
Mailing address
3036 PHILIPS HWY APT 116, JACKSONVILLE, FL 32207-4377
(904) 718-2556
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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