Bethany Jackson
NPI #1003612151 in Bloomington, Illinois
Provider Information
- NPI Number
- 1003612151
- Entity Type
- Individual
- Name
- Bethany Jackson
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Feb 20, 2025
- Last Updated
- Feb 20, 2025
Practice Location
- Address
- 1015 S MERCER AVE
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61701-7107
- Phone
- (309) 663-0488
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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