MICHAEL BRYAN STACK

JACKSON, MS
NPI1013618065
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy106S00000X Behavior Technician
(Licence: MS  RBT-22-226002)
Enumeration Date2023-03-16
Last Update Date2023-03-16
Business Address
MICHAEL BRYAN STACK
1513 LAKELAND DR
JACKSON, MS 39216-4829
Phone number: 769-777-1000
Mailing Address
MICHAEL BRYAN STACK
1606 LAUREL ST
JACKSON, MS 39202-1243
Phone number: 601-942-4089
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