Individual
LILIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2500 RENAISSANCE BLVD STE 170, KING OF PRUSSIA, PA 19406-2639
(484) 681-2170
Mailing address
2500 RENAISSANCE BLVD STE 170, KING OF PRUSSIA, PA 19406-2639
(484) 681-2170
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-26-2830315
PA
Other
Enumeration date
08/04/2026
Last updated
08/04/2026
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