Angela Jackson

NPI #1710575725 in Midway, Georgia

Provider Information

NPI Number: 1710575725
Entity Type: Individual
Name: Angela Jackson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Jan 5, 2021
Last Updated: May 22, 2022

Practice Location

Address: 72 DRAYTON CT
City: Midway
State: Georgia
ZIP Code: 31320-7142
Phone: (404) 697-3608

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X
Behavior Technician	106S00000X	Primary

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