Tanya L Jackson, ABA TECHNICIAN

NPI #1639527112 in Benton Harbor, Michigan

Provider Information

NPI Number: 1639527112
Entity Type: Individual
Name: Tanya L Jackson, ABA TECHNICIAN
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Credential: ABA TECHNICIAN
Enumeration Date: May 25, 2016
Last Updated: May 25, 2016

Practice Location

Address: 1220 PEARL ST
City: Benton Harbor
State: Michigan
ZIP Code: 49022-5539
Phone: (269) 252-1540

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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