Individual
MRS. CRISSY STARR JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LBA, IBA
Contact information
Practice address
1434 N LUCY MONTGOMERY WAY, OLATHE, KS 66061-6706
(913) 242-5181
Mailing address
1434 N LUCY MONTGOMERY WAY, OLATHE, KS 66061-6706
(913) 242-5181
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1811089014
VA
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/25/2018
Last updated
08/15/2022
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