CANON PEYTON JACKSON

BOWLING GREEN, KY
NPI1568080133
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy106S00000X Behavior Technician
(Licence: KY  RBT-20-115930)
Enumeration Date2020-07-10
Last Update Date2020-07-10
Business Address
CANON PEYTON JACKSON BS
2427 RUSSELLVILLE RD
BOWLING GREEN, KY 42101-3980
Phone number: 270-936-7472
Mailing Address
CANON PEYTON JACKSON BS
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS, IN 46268-6135
Phone number: 855-324-0885
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