Dominique Jackson
NPI #1699544783 in Powder Springs, Georgia
Provider Information
- NPI Number
- 1699544783
- Entity Type
- Individual
- Name
- Dominique Jackson
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Dec 29, 2023
- Last Updated
- Dec 29, 2023
Practice Location
- Address
- 5330 RUTLAND CT
- City
- Powder Springs
- State
- Georgia
- ZIP Code
- 30127-4785
- Phone
- (404) 913-6337
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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