Shalia Jackson
NPI #1104608652 in Bridgeport, Michigan
Provider Information
- NPI Number
- 1104608652
- Entity Type
- Individual
- Name
- Shalia Jackson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Oct 19, 2023
- Last Updated
- Oct 19, 2023
Practice Location
- Address
- 6296 BRIDGEPORT VILLAGE SQUARE DR STE 2
- City
- Bridgeport
- State
- Michigan
- ZIP Code
- 48722-9655
- Phone
- (989) 401-1239
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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