Individual
JACQUELINE THWEATT-BURTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
530 SCARCE CREEK RD, LEXINGTON, TN 38351-8561
(731) 614-3101
(228) 300-2113
Mailing address
708 BROAD AVE, GULFPORT, MS 39501-1350
(251) 648-4346
(228) 300-2113
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06888361
—
MS
Enumeration date
05/22/2020
Last updated
07/20/2022
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