Micha Jackson

NPI #1164179420 in Cape Girardeau, Missouri

Provider Information

NPI Number: 1164179420
Entity Type: Individual
Name: Micha Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Mar 7, 2022
Last Updated: Mar 7, 2022

Practice Location

Address: 3037 LEXINGTON AVE
City: Cape Girardeau
State: Missouri
ZIP Code: 63701-2602
Phone: (573) 708-7250

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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