Mary Jackson
NPI #1275144149 in Glen Carbon, Illinois
Provider Information
- NPI Number
- 1275144149
- Entity Type
- Individual
- Name
- Mary Jackson
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Analyst
- Enumeration Date
- Aug 13, 2020
- Last Updated
- Jul 3, 2023
Practice Location
- Address
- 4559 BENES AVE
- City
- Glen Carbon
- State
- Illinois
- ZIP Code
- 62034-1541
- Phone
- (217) 525-8332
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Analyst |
| Assistant Behavior Analyst |
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