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1508621731
EBONY LOUISE JACKSON
SUMMERVILLE, SC
NPI
1508621731
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CO 23-268294)
Enumeration Date
2024-02-16
Last Update Date
2024-02-16
Business Address
EBONY LOUISE JACKSON
1711 CENTRAL AVE
SUMMERVILLE, SC 29483-9320
Phone number: 843-934-1981
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Mailing Address
EBONY LOUISE JACKSON
414 GRAY BARK RD
SUMMERVILLE, SC 29486-8302
Phone number: 720-827-6055
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