Individual
MRS. SHANTAL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
121 S HIGHLAND AVE, APT 2B, OSSINING, NY 10562-5862
(914) 432-5670
(914) 432-5670
Mailing address
121 S HIGHLAND AVE, APT 2B, OSSINING, NY 10562-5862
(914) 432-5670
(914) 432-5670
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-09-05861
NY
Other
Enumeration date
08/15/2014
Last updated
08/15/2014
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