Individual
ANGELICA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11010 DAVID TAYLOR DR, CHARLOTTE, NC 28262-1574
(704) 780-4271
(888) 261-6649
Mailing address
11010 DAVID TAYLOR DR, CHARLOTTE, NC 28262-1574
(704) 780-4271
(888) 261-6649
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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