Individual
BENJAMIN ADAM JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
100 COMMERCE CT, POOLER, GA 31322-9445
(615) 560-6622
Mailing address
8 ROSEBERRY CIR, PORT WENTWORTH, GA 31407-5612
(904) 767-1215
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/05/2024
Last updated
11/08/2024
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