Michael Bryan Stack
NPI #1013618065 in Jackson, Mississippi
Provider Information
- NPI Number
- 1013618065
- Entity Type
- Individual
- Name
- Michael Bryan Stack
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Analyst
- Enumeration Date
- Mar 16, 2023
- Last Updated
- Jan 6, 2026
Practice Location
- Address
- 1513 LAKELAND DR
- City
- Jackson
- State
- Mississippi
- ZIP Code
- 39216-4829
- Phone
- (769) 777-1000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Analyst |
| Behavior Technician |
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