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1376151266
SAMUEL ELI JACKSON
COLUMBUS, GA
NPI
1376151266
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103K00000X Behavior Analyst
(Licence: GA 12369125)
Additional Taxonomies
106S00000X Behavior Technician
Enumeration Date
2020-07-16
Last Update Date
2023-10-25
Business Address
SAMUEL ELI JACKSON
1110 13TH ST STE D
COLUMBUS, GA 31901-2246
Phone number: 706-780-1704
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Mailing Address
SAMUEL ELI JACKSON
1110 13TH ST STE D
COLUMBUS, GA 31901-2246
Phone number: 706-780-1704
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