Individual
DANISHA LATREECE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5900 WARM SPRINGS RD STE J, COLUMBUS, GA 31909-4597
(706) 786-1110
Mailing address
5900 WARM SPRINGS RD STE J, COLUMBUS, GA 31909-4597
(718) 215-5311
(706) 786-1110
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/15/2025
Last updated
07/15/2025
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