Individual
JACQUELINE LANDA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., BCBA
Contact information
Practice address
901 W TRADE ST, CHARLOTTE, NC 28202-1143
(718) 736-5689
Mailing address
2560 JUDGE FRAN JAMIESON WAY UNIT 1309, MELBOURNE, FL 32940-6199
(860) 759-8726
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1123
CT
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/01/2021
Last updated
08/04/2023
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