Tyla Jackson
NPI #1215420435 in Pawtucket, Rhode Island
Provider Information
- NPI Number
- 1215420435
- Entity Type
- Individual
- Name
- Tyla Jackson
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Case Manager/Care Coordinator
- Enumeration Date
- Jun 12, 2018
- Last Updated
- Dec 11, 2020
Practice Location
- Address
- 70 WOOD ST APT 22
- City
- Pawtucket
- State
- Rhode Island
- ZIP Code
- 02860
- Phone
- (161) 751-6777
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
| Case Manager/Care Coordinator |
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