Individual
MR. VINCENT MAURICE JACKSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
875 MASS AVE UNIT 205, INDIANAPOLIS, IN 46204-1652
(317) 679-5849
Mailing address
875 MASS AVE UNIT 205, INDIANAPOLIS, IN 46204-1652
(317) 679-5849
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/01/2014
Last updated
07/01/2014
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