| NPI | 1114686524 | 
|---|---|
| Other Name | SOPHIE JACKSON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 1-24-73979)  | 
| Additional Taxonomies | 106S00000X Behavior Technician | 
| Enumeration Date | 2021-12-13 | 
| Last Update Date | 2024-07-24 |