Individual
NADIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
44 IRVING ST, VALLEY STREAM, NY 11580-1635
(516) 884-1012
Mailing address
44 IRVING ST, VALLEY STREAM, NY 11580-1635
(516) 884-1012
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1145472
NY
Other
Enumeration date
06/28/2013
Last updated
06/28/2013
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